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HomeMy WebLinkAboutBIRCH TREE ESTATES BLK 1 LT 5Birch Tree
Estates
Block 1
Lot 5
#017-141-46
Municipality of Anchorage f
On -Site Water and Wastewater Program - (907) 343-7904 gev 1 "bf 2
ON-SITE WASTEWATER INSPECTION REPORT
OSP181076
Permit Number: PID Number.- 017-141-46
Dwelling: ❑■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New 0 Upgrade
Name:
Matt Sulivan
ABSORPTION FIELD
❑ Deep Trench ElShallow Trench E] Bed [:]Mound
Address
5200 Riverton Ave., Anchorage
XOther _S�j, SUV147 Ce brit
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
23 GPD/SF
7.1 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
6.1 Ft.
Gravel depth beneath pipe
1.0 Ft.
Subdivision Block Lot
Birch Tree Estates 1 5
Fill added above original grade
0.6 Ft.
Gravel length
11 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding {Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank Line
62.5 Ft2
1
Ft.
Well100+
100+
25+
TANK El Septic ElS.T.E.P. ❑ Holding X Other
Manufacturer
BioBarrier w/Infiltrator Tanks
Capacity
540 and 1530 Gal.
Surface Water
100+
100+
Material
Number of compartments
Lot Line
3*
10+
HDPE
1 and 2
NA
Foundation
5 +
10
LIFT STATION
Manufacturer
Capacity
Curtain Drain
None
[Known
I
Gal.
Remarks *from east lot line, 1,waiver on file
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
Installer
PIPE MATERIAL House to tank D3034 Tank to
drainfield D3034
ARM Services
Drainfield D3034 CO/MT 3034
Inspector Crewdson Engineering LLC
BENCH MARK (Assumed elevation) 100 ft
I115Pdates: is' 7-5-18
7-5-18 ctionLocation
and description
2°�
3rd 7-9-18 — 4`n 8-3-18
Patio Door Threshold: "BM" on record drawing
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
=
Conditional
.r F A4gsll
' • ' i
Approval: Date
.i AQ' ..�-
-
0001
... .... z ..
-----
- - —--
�� s' • ames A. Crewdson .'
— - -- --- -- -
Approved V�7Ut � Date 30 1`1
/
C115274.
1k�\AOFESSIONP��
A I D kf 59 6 kL
ALLC #112279
inspection Keporr_y- i - il.aoc
RIVERTON AVE. SUBSURFACE DRAIN -
5'W x 11'L x VED I
C2
B1130
/C3 &I
DECK TTI' M2
62
Cr MT C4 C1
M1 Q
BM �
U FC
� B �
3 BR SFH '
PLAN
SCALE: I"=20, SWING TIES (FEET)
FC C1 C2 C3 C4 M1 M2 M3 MT
A 18.0 29.9 34.5 24.9 19.5 29.4 1 31.0 34.6 1 17.6
B 13.3 31.4 47.2 40.6 30.5 27.7 35.2 44.0 30.9
NOTES
1. 2" INSULATION PLACED ABOVE ALL TRANSMISSION
PIPES AND TANKS
BENCH MARK
PATIO DOOR THRESHOLD
ELEV 100' C1
M1
96.5'
INLET ELEV-J Infiltrator IM -540
INV 95.9' SEPTIC TANK
Clrewdson Engineering, LLC
Vic, cam"
Civil & Environmental Engineering
PO Box 671389 Chugiak AK 99567 . cellc.l@outic
Cellrrext:907-280-9493 . Fax: 907-688-2295
M2
ZED SF
ORIENTED 45°±
FROM VERTICAL
IoBarrier
TREATMENT:
I IM -1530 TANK
—1---BioBarrier
SETTLING:
IM -540 TANK
LOT 4
PROFILE
NOT TO SCALE
/ EG 99.2' M3
FG 99.7'
TOT ELEV
96.4'
Infiltrator IM -1530 OUTLET ELEV
SEPTIC TANK INV 95.8'
Birch Tree Estates, Block 1, Lot 5
Septic System Inspection Report
Record Drawing
Plan and Profile
Prepared for: Matt Sullivan Date: 11-16-18
Permit: OSP181076 Page: 2 of 2
ALL INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY Oi- CREWDSON ENGINEERING. LLC AND EHALL NOT BE USED FOR
ENGINEERING OR CONSTRUCTION FURPOSES WITHOUT WRITI EN PERMISSION FROM CREWDSON ENGINEERING, LLC
LEGEND
B# - blower
BM - bench mark
BR - bedroom
C# - cleanout
CP - control panel
ED - effective depth
EG - existing ground
ELEV - elevation
FC - foundation cleanout
FG - finish grade
IAW - in accordance with
INV - invert
M# - manhole
MT - monitor tube
SF - sand filter
SFH - single family home
TOT - top of tank
��b'P�v • . �8�9`I
j�---...
ames A. Crewdson
C1527
�sj •
It -0 � —1
F�FVpROFNsk
ALLC #112279
OF g4�1`i
Municipality of Anchorage
Development Services Department
•,• / Fi p
Building Safety Division
® On -Site Water and Wastewater Program / • "S 0
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 :James A, Crewdson —
www.ci.anchorage.ak.us d
(907) 343-7904 9Fo 011527
c
Soils Log - Percolation Test litk\ FESStOo?�.�
Performed For: Matt Sulivan
Legal Description: Birch Tree Estates, Block 1, Lot 5
TH 1 F__
Depth
(Feet)
1- U�
2-
4-
5-
6- S /j�
7-
8-
9-
10-
11-
12-
13-
14��.�
15-
16-1
17-
18-
19-
20 -
SEE DESIGN
Date Performed:
Township, Range, Section:
Site Plan
WAS GROUND WATER
Date
ENCOUNTERED?
Net Time
Depth of Water
/ end)
s
IF YES, AT WHAT DEPTH?
L
Depth to Water After
o
P
Monitoring?
E
Date:
I I I SEE DESIGN I I I I
I I I SEE DESIGN I I I I
Reading
Date
Gross Time
Net Time
Depth of Water
/ end)
Net Drop
(inches)
—(minutes)
/('start
3
4
5
6
x minutes
PERCOLATION RATE j/_ (minutes/inch) PERC HOLE DIAMETER 6 inch
TEST RUN BETWEEN _ S` FT AND (� FT
COMMENTS Presoak not required in sandy soils
PERFORMED BY: Crewdson Engineering LLC ► James Crewdson CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
_RIVERTON AVE.
O
0
M
tSEPTIC BOX (TYP)
ci ©24" MANHOLE (TYP)
O
ELEC.
PED
6 `
SEPTIC STANDPIPE
WATER WELLWO
16.4'
i A
Wood Deck
`ROCK WALK
FENCEXX
CO
El
I
�
5�s
8/15/2018
x
Phone 562-5291
DRAWN BY:
ADS/SC
PLAT:
71-215
Mainline
Phone 243-8985
12.6'
SC
5
SW3037
'S�''
is
•- LOT 4
+
\� x
o
I
Z
s_f
... _..•.• .. ;r.�Y.Lv:KCJLIIVU .-,>. I
.. � � 20.3 N �.-.•.-:c..-.jSANi3)>'::_;. ;i
-N, SHED
20.3 ..... ;....
.................................................
X .....X X. _ R -X - X, X X -
N890 43'44"E 143.00'
_O
0
p�•`� . O \ rkp4 LOT 13 LOT 14
9TH**
TH �D
n............................On
STEVEN CALLAGHAN
�,./-12034
Ip Z:• ae
���� fessiono� �'Qo
NOTE:
THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN
WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH.
ORDERED BY: MATTHEW SULLIVAN PARCEL M 017-141-46-000 SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF
THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THATTHE
LEGAL DESCRIPTION: ADDRESS: 5200 RIVERTON AVENUE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO
ENCROACHMENTS EXIST OTHER THAN NOTED.
AS -BUILT
LOT 5, BLOCK 1,
BIRCH TREE ESTATES SUBDIVISION
I Inc
a&Werfc ne ' engem&avgi-g
EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE
EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY
TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO
CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR
ESTABLISHING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES.
250 H Street
SEPTIC STANDPIPE
WATER WELLWO
Anchorage, Alaska 99501
Wood Deck
`ROCK WALK
FENCEXX
SEPTIC UTILITY BOX
El
Department
DRAWN DATE:
8/15/2018
WORK ORDER: 18031
Phone 562-5291
DRAWN BY:
ADS/SC
PLAT:
71-215
Mainline
Phone 243-8985
CHECKED BY:
SC
GRID:
SW3037
SCALE:
1" = 30'
FB/PG: 808/71-73
-7/5//g' 'T
d'JN``'P"t'ry 0, MUNICIPALITY OF ANCHORAGE ,0,,nr._ Y r7(
On-Site Water&Wastewater Program ��' .
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http://www.muni.org/onsite
I)t 11.111 inlnt
S k C HORP66
On-Site Wastewater Disposal System Permit
Permit Number: OSP181076 Effective Date: 6/20/2018
Work Type: Septic Upgrade Expiration Date: 6/20/2019
Tax Code Number: 01714146000
Site Legal Address: BIRCH TREE ESTATES BLK 1 LT 5 G:3037
Site Mailing Address: 5200 RIVERTON AVE, Anchorage
Owner: SULLIVAN MATTHEW S &AMIE M Lot Size in Sq Ft: 27856
Design Engineer: CREWDSON ENGINEERING, LLC Total Bedrooms: 3
This permit is for the construction of:
0 Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
1. This system is being tested for Advanced Wastewater Treatment System approval. If it does not meet
requirements. it may need to be replaced.
2. A percolation test shall be completed prior to construction of the subsurface drain to confirm the application
rate. If the results require a design change, construction of the drain shall stop pending On-site review and
approval. Please submit stamped and signed results with the inspection report.
•
r; /
Received By: Date: (? - 0 U - / c
Issued By: ' ' avz..69-1, Date:
6/10/(?
•
a nr
Municipality of Anchorage + t=
1)cpal'tmcnt
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 e (907) 343-7904 • Fax (907) 343-7997
http://www.muni.orq/Onsite
Development Services Department
On-Site Water and Wastewater Section
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV181020 COSA#: Permit#: OSP181076
PID#: 017-141-46
Legal Description: Birch Tree Estates Block 1 Lot 5
Engineer: Crewdson Engineering
Applicant: Matt Sullivan
Your request for a waiver of the required 10 feet horizontal separation from the septic tanks to
the property line has been approved. The approved separation distance is 5.0 feet to the north
property line and 1.0 foot to the east property line. See engineer's waiver request letter and
neighbor's septic installation easement letter.
This waiver approval applies to the proposed septic tanks only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
Waiver is Granted: X Waiver is not Granted:
Date: 6/20/1g Approved by: -47A (�w7cYlg
Name of Reviewer
*'k** VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
Development Services Department ": Phone: •I 3-7904
On-Site Water & Wastewater Section F-• ,.4. 1.4 . - 1':7 97
Migin
MAY 032018
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 017-141-46 o1 6 9��w
8
Property owner(s) Matt Sullivan Day phone
Mailing address 5200 Riverton Ave., Anchorage, AK 99516
Site address same
Legal description (Sub'd., Block & Lot) Birch Tree Estates, Block 1 , Lot 5
Legal description (Township, Range & Section)
Lot Size 27856 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field Initial Single Family (SF) x
(w/wo AD U)
Septic Tank 0 Upgrade n Duplex (D) ❑
Holding Tank ❑ Renewal — Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage LJ
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Lot Line Distance: 1-foot
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipa/Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 54 Waiver Fees: a�S
Date of Payment: 5/1-11ig Date of Payment: olg1 t g
Receipt Number: 6800&) Receipt Number: ()g
Permit No. CJS P1'310'1(0 Waiver No. l V(3I6gO
G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
Crewdson Engineering, LIC
James"Jay" Crewdson, P.E.
Email: CELLC.1@outlook.com
Cell/Text: (907) 280-9493
Fax: (907) 688-2295
Civil&Environmental Engineering
May 20, 2018
Onsite Reviewer
Municipality of Anchorage
On-site Water&Wastewater Program
4700 Elmore Road
Anchorage, AK 99519-6650
Reference: Birch Tree Estates, Block 1, Lot 5
Septic System Upgrade
Design Narrative and Lot Line Waiver Request
The owner of the 3-bedroom home would like to replace the failing septic system. There is not enough
undisturbed ground available on the southwest side of the home to install a septic system drainfield and
the existing septic tank is under the driveway.
The design requires the existing septic system to be decommissioned in accordance with the code and
proposes to install a new septic system near the northeast corner of the property. The location is
relatively small and requires an advanced wastewater treatment system to reduce the drain size and a 1-
foot lot line waiver for the septic tanks.
The 1-foot lot line waiver we are requesting will not impact the adjacent property owner's ability acquire
a septic system upgrade permit.
The septic system will use a BioMicrobics, Inc. BioBarrier 0.5-N Membrane BioReactor (MBR) sewage
treatment system. The effluent produced by the MBR will be discharged into the proposed drain, which
its size will be verified prior to construction with a percolation test. Although soils tests in the area indicate
faster soils are likely to be found, the design is taking a conservative approach by using 30-60 mpi.
Although not part of this permit,the project also includes replumbing the house drain-waste-vent system
to be exiting on the northeast side of the home.
Please feel free to contact me if you have any questions. r�� OF 444% ,,
n,,� i�P • • •
• �f'/ Imo •
• •1•
James"Jay" Crewdson, P.E. •
/1Jar es •.Crewdson
/I • C1157 •
/{LLC, 11).J)-(4
PO Box 671389 • 18368 Amonson Road • Chugiak,Alaska 99567
\ \ r 5.0'
S89°51' 09"W `143.00 1 L ____
\ iT6 h
--t6%
\ 1-----(W/
P) BioBarrier 0.5-N
}Op 0 3' SAND FILTER,
th o EA I 2" INSULATION
0 0 —1.0'
° WELL m m
P 1 r CO T \
P) DRAIN W/
O / \ 2" INSULATION
0) c1 \4Dx5Wx8L
/ \SEE NOTES
(P)FC \
/LOT5
/ 3 BR SFH / \/00.
/ / \*-
LOT4 \�O• �
DWY . \Gs
GENERAL LOCATION OF (E) SEPTIC SYSTEM, •
COMPLETELY DECOM IAW THE CODE, °?
REFERENCE THE ATTACHED Robert B.•Johns, JR. rn
3/13/14 ASBUILT SURVEY FOR EXACT LOCATION
zo
PLAN
0
SCALE: 1"=20'
0
i' Z
NOTES LEGEND GRW-groundwater
1. All components shall be installed IAW MOA,DES and BMI (E) existing IAW-in accordance with
requirement's. (P) proposed MBR-Membrane Bioreactor
2. Construction requires Level 1 and Level 2 DES certified contractors. ABO-Above Bottom Of MD-Mixing Device
Level 1 contractors complete all required excavation,backfill,and AMC-Anchorage Municipal Code MOA-Munic.of Anch.
placement/installation of tanks and external piping. BB-BioBarrier MBR MPI-minute per inch
Level 2 contractors install all required septic treatment equipment, BGL-below ground level MT-monitor tube
coordinate with the electrical sub-contractor and complete the BMI BMI-BioMicrobics Inc. MWL-Maximum Water Level
required system startup procedure. BR-bedroom OWL-Operating Water Level
3. Level 1 and Level 2 contractors shall be MOA certified installers. CO-cleanout SF-square foot
4. The septic tanks shall be installed IAW the attached CPEP-Corrugated Polyeth. Pipe SFH-single family home
"Infiltrator IM-Series Tank Installation Manual" DC-double CO SNDF-Sand Filter
5. The minimum drain size shall be based on a flow rate of 150-GPD/BR DES-Denali Environmental Supply ST-Septic Tank
6. Assumed 30-60 MPI soils,verify prior to construction and revise the EG-existing ground TU-Treatment Unit
design as needed,submit results with the inspection report. FC-foundation CO W/-with
7. The entire(P)septic system shall be insulated with 2"min insulation. FG-finish grade
Crewdson Engineering, LLC Birch Tree Estates, Block 1, Lot 5 %,OF q x\l
.QI Septic System Upgrade /'*�k`P.• ;� 79*�r
P Y p9 • 4s 6�
DESIGN A %
mes A.Crewdson .
4 . roe
.Q, - Prepared for: r+�1%), • _C11527 .�``4�
Civil&Environmental Engineering Matt Sullivan Date: 5-20-18 it o. ....,..��"
PO Box 671389 Chugiak AK 99567 • cellc.1@outlook.com Permit: OSP181076 Page: 1 of 2 \‘N�\"` -��
Cell/Text.907-280-9493 • Fax.907-688-2295
lALLC#112279
L INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREV.OSON ENGINEERING,LLC AND SHALL NOT BE USED FOR
ENGINEERING OR CONSTRUCTION PURPOSES WIIHOUI WRITTEN PERMSSION FROM CREWDSON ENGINEERING.LLC
24"0 CPEP RISER W/LIDVENT OUTLET
INSULATED(3 TYP) ------ 410 PVC 4"0 PVC
OPEN END
F
INLET/BAFFLE EFFLUENT LINE III 3'SNDF
4"0 PVC 72"MAX ABO TU 4121 PVC
24"MIN INDEPENDENT ik
1-4---1 FLOAT STAND I -
11NImIq / I - SI
I
PARTITION 1 �I�
I SEE DETAIL P1 \ I f 45"
47 BB 45" 47" BB MD 49 I BB TU l
SaniTEE / MWL 38"
I OWL
Lll / CONNECT TO
(P)DRAIN
SETTLING ZONE TREATMENT ZONE SEE PLAN
Infiltrator® IM-540 TANK Infiltrator® IM-1530 TANK
NOTES TABLE 1. BioBarrier®SUBSURFACE DRAIN
1. COMPONENTS AND EQUIPMENT SHALL BE IAW THE MOA"STANDARDS AND SOIL PERCOLATION RATE DRAINAGE RATE
SPECIFICATIONS FOR COMPONENT PARTS AND MATERIALS USED IN (MIN/IN) (GPD/SF)
CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS" 1--5 50
2. COMPONENTS AND EQUIPMENT SHALL BE IAW THE MOA BioBarrier®0.5-N 6--15 23
APPROVAL REQUIREMENTS 16--30 14
3. BioMicrobics®EQUIPMENT SHALL BE INSTALLED IAW BioMicrobics® 31--60 6
INSTALLATION REQUIREMENTS 60--120 3
4. Infiltrator®COMPONENTS SHALL BE INSTALLED IAW"Infiltrator IM-Series Septic 120--240 1.7
Tank General Installation Instructions"and "Infiltrator IM-Series Tank Buoyancy NOTE
Control Guidance" 1. SIZE AND CONSTRUCT NEW DRAINFIELDS
5. THE CONTRACTOR SHALL ACQUIRE ALL BioMicrobics®, Infiltrator®AND Denali IAW AMC 15.65.010 WIDE TRENCH AND
Environmental Supply(DES)COMPONENTS DIRECTLY FROM DES UNLESS AMC 15.65.210.D2b WIDE TRENCHES USING
EXPRESS PRIOR WRITTEN APPROVAL HAS BEEN ISSUED TO THE TABLE 1 DRAINAGE RATES
CONTRACTOR
ti
4"21JO
REMOVE 2"0J I
HIGHLIGHTED (3 TYP) 34„38”
AREA Y 36"— ,
III
%r. 12"
DETAIL P1 SCALE NTS
PARTITION HOLES & CUTOUTS
NOTE
1. PARTITION 1 IS MODIFIED IAW THIS DETAIL
AND PROVIDED BY DES
Crew4son_,Engineering, LLC Birch Tree Estates, Block 1, Lot 5 _��,�F q \‘
ir�Q� `qs4-1
-(..M BioBarrier 0.5-N %* 49 '• %` *+4
DETAILS
,' J:mes A.Crewdson
.,,�� 10 C 11527 4, Aily
Civil&Environmental Engineering Prepared for: Matt Sullivan
Date: 5-20-18 ITI1,1Flk�' : �`-, ���Aw
PO Box 671389 Chugiak AK 99567 • DEiiD.,@DLAIOOk.co Permit: OSP181076 Page: 2 of 2 \��N`••"•`��
cenrrexr 907-280-9493 • Fax 907-688-2295 ALLC #112279
AU.INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREW950N ENGINEERING.LLC WE
C AND SHALL NOT RE USED FOR
ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMSSION FROM CRE WOSON ENGINEERING.LLC
/.. ie RIM
"K'ar" al "°a"°e
mom camar
a101a'Ladle IMO(
ant..ams.�« b RIVERTON AVENUE :,.
.
Il`"I`"n° S89° 51'09'W 143.00'
't
WELL
% ...ill" I
FI
c03 s
.f '` , EXISTING11 co
.'t HOUSE ,
C.O.s ' ,• p
4
\ 'S' 1 Za
w
to
m M..H.
gi
CO
10'UTIL ES1AT
143.00' N89°43'44°E
UNDER NO CIRCUMSTANCES SHOULD AN AS--BUILT BE USED FOR CONSTRUCTION CR FOR ESTABUSHING BOUNDARY OR FENCE LP ES.
{ THE SURVEYOR TAKES RESPONSIBILITY FOR NE 04I11AL TRANSACTION ONLY ANO ASSUMES FINANCIAL UABLUTY ONLY FOR THE COST OF THE SURVEY.
LI51ED DISTANCES PREVAIL OVER SCALING, REPRODUCTION MAY CAUSE ERRORS NN SCALE.
Lot 9wwyy SURVEY TYPE
fOlA0A11oN as-aucT SYMBOLS
❑ FSLAL STRUCTURE AQ-6uLT • SET REBAR M DRAINAGE
PLAT PLAN. ..AS-Pu T. ..LOT SW. ._IOPOpRM{t 0 FOUND REBAR .0-4-0. MOOD FENCE 14:. :-.N CONCRETE
As-ILIILL.. .NO s LET 0 RECISIFICAIXIII As-BAT. •.no cormattap ® AS3JMED ELEv. x METAL FENCE Wardri woo DECK
PLOT PLANS & LOT SURVEYS NOTE:
I IT IS THE R'ESPONSIENUTY OF NE BUILDER OR OMNER. PRIOR TO ONLY THOSE IMPROVEMENTS APOVE GROUND AND VISIBLE *ILL BE
CONSTRUCTION, TO VER*FY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, %ELLS, SEPTIC CLEANOUTS, skit-WALKS. DRIVEWAYS,
TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SNOW
THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
WHICH DO NOT APPEAR ON THE RECORDED SUBD1V1S3ON PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED.
SURVEY CERTIFICATION Prepared by
PLOTN ••e •�,, „ '� Robert E. Johns, Jr. & Assoc.
dr net far sr`..`..•.••��.NI.wI '�P•••''• Professional Land Surveyors
Nor r.....www.w+.1st..... ?Gj�.•• 1700 Brink CrM.
ao amen al .V�.�I�M^.... s ` A ANCNORAOE, ALASKA 9'604
FOUNDATION AS-SINLT ..,- .� 1`-,.. .. Sedgy 1 N 401 Rec. Lot S.F. Roc Plat FM.No.
a •pr E s/an Jr..i.r..y..r.y...R I •• Data
.r prams/an I" .'r^:w.. s r.... ....1,....: �"r" 03113114 'o.o.n bs REJ mads° 1MK
w.w....l.Na..11w a r...w Mow'_ ry r
ww�.w.....rram.•M•w..w....mu... • ROBERT= ..
FINAL sTxuckst As-«llLT �►A%'b�' 4121—s ; is
'`je4 Data prom: 03/13/ 4 ` 3037 rit W.O.
14-78
bra prawroll re M-lbal °^rtl' k_In, •••.. ..•�as,4.` �I: Lot 5 Block 1
4/0 1/101 Old 40 0040041404011 Silt Mem +400, BIRCH TREE ESTATES
jr. . .
Municipality of AnchoragePam / of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number SO /?8o/( Y PID Number. 00-JV1'_ Yee
Name:
Wastewater System: 0 New .9 Upgrade
,[iFwp.�cE ckA-Tim i�
Address: ABSORPTION FIELD
,50100 Pi t/F-4%a.g Qua,4L,c ALS 95L5--/6
Phone: No.of Bedrooms: 0 Deep Trench la Shallow Trench 0 Bed 0 Mound 0 Other
3(45'-U(a9a .3
LEGAL DESCRIPTION Soil Rating. Total Depth from original grade:
� GPP/So.Ft. e)• 5
Lot Block: Subdivision: Depth to pips bottom from original grade: Gravel depth beneath pipe
/ Zl Rc 1-)2E-6-- CS>AT£S l• S Ft. / Ft,
Township: Range: Section: Fill added above original grade: Gravel length:
— 1 Ft. 1,6, Ft.
- ErvsyLJ New ❑ Upgrade Gravel width: r Number of lines: Distance batweenQnes
J Ft. EL
Classification(Private, Total Depth: Cased To: Total abeorapn area: Pipe metrial: Aa r- 4 3 o 3 il
Ft Ft. 374- SQ.Ft. Sc--N 0.i0 Pv GI f_yip
Driller: Drilled: Static Water Unlit InstallerDate installed:
Ft. u,�t,� xc. Cori/ f alb
Yield: Pump Set at: Casing `row TANK
GPM Ft_ Ft
SEPARATION DISTANCES ❑septic O Holding fri.S.T.E.P.
To septic Absorption Lift Holding Pubilo/Prhats MOnufacfurer: Capacity In gallon&
From Tank Field Station rink Sewer Lines N a v 74,</k" $0 0
Material: Number of Compartments:
Welk
MO /oo' //a ' .7--- STl-"CL ol
w� t//A ` LIFT STATION
• Lot , / y / Si;t in gallons Manufacturer
Une 3' 3 4- ,SOC AN JoRrA jE' 7A)fk
•Pump on"level at "Pump ofr level tit: High watealarm et
Foundation /d' CP3' G901 p„ j g/" l .39 "
Curtain �I w.,c L/✓w, 711 _ n Pump Make&Model Electrical Inspections performedby:
Drain )0 GIS/ aSl-/fl lM• 0. 4.
Remarks: E, , S r/N(r T AC., c H coM/rl,trd,y BENCH MARK
Location and Description:
Asit,00,,,c0 ( 4NcreoecNEG C.,e,.)tia w,sri�� 173It = Tgp , f GIIR,5c
4- WNrvivt d E 4ait..s TEA 44;r.•dt4.,i r,,tycl/i,fk-O S LAd AT Call?,r,:e L
Assumed Elevation:
T 44•..e.a/ 4Nn 1,y4.57- PetdPiArY La,,,f . /a tf Ela
C2,
3 S F.Na1NEERIN(i , /
17034 Eagle River Loop Road �_ t..... •••, .
Inspections performed by: �1*liter,Alaska vin %Mk i istt f i-9 8. # ........,.,_„
,
2nd -i'i ?S Keen C. COWAN/it
3 d 6,-/R-98" t o\ CE-8801 .•• <�?.►
Department of Heal and uman Services approvallit i,pFJ•�, .�..;. ,
Reviewed and approved by: 27ta( i >t `� Date: �`24`� ,i�i��'��-"`'y
72-013(Rev.Wel)140A 25
Septic Installation Easement
I, Don Millar, owner of 5220 Riverton Ave., Anchorage, AK 99516; will allow access
through my property for the purpose of installing a new septic system at 5200 Riverton
Ave., Anchorage, AK 99516. This installation easement will be in force for the duration
of the install.
on Millar
5220 Riverton Ave
Anchorage,AK 99516
----ffab 'Ir 6'/3k.'9
Matthew Sullivan
5200 Riverton Ave
Anchorage, AK 99516
6+'
'
4..
itAtYi
,y
4
fL!
1
G nV
Municipality of Anchorage e'
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW040157 PID Number: 017-141-46
Name:
Rand Uhart
Wastewater System: ❑ New ® Upgrade
Address:
ABSORPTION FIELD
5200 Riverton Drive, An horse AK 99516
Phone: Number of Bedrooms:
❑ Deep Trench [3 Shallow Trench ®Betl ❑ Mound ❑Other.
LEGAL DESCRIPTION
Boll Rating:
Total Depth from original grade:
0.7 GPWFF
1.0 Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grace:
Gravel depth beneath pipe:
1 5 Birch Tree Estates
0.5 Ft.
0.5 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
1.76 var. Ft.
65 Ft.
Well: ❑ New ❑ Upgrade
Gravel mcith:
10
Number of lines:
2
Distance between lines:
3
Ft.
FL
Classification (Private, A, B, C):
Total Depth:
Cased W:
Total absorption area:
Pipe Material:
Private -EXISTING
Ft.
Ft.
650 Fl
D3034
Driller:
Date Drilled:
Static Water Level:
Installer:
Date Installed
Ft.
Anderson 1
6/4/04
Yield:
Pump set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
® Septic []Holding ®S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity:
From
Tank
Field
Station
Tank
Sever Line
EXISTING
Gal.
Well
100'+
100'+
NA
NA
25'+
Material:
Number W Compartments:
Surface Water
100'+
100'+
NA
NA
LIFT STATION
Lot Line
5'+
10'+
NA
NA
W:
EXISTING
Manufacturer:
Gal.
$'+
10'+
NA
NA
"Pump on" level at:
'Pump off level at:
High water alarm at:
Foundation
in
in.
in.
NA
*50'+
NA
NA
Pump Make & Model
Electripl Inspections performed by:
Curtain Drain
*none known
non
BENCH MARK
Location and Description:
Field insulated
Top of garage slab
Assumed Elevation:
100 Ft.
Engineer's Stamp
=ICQ�E'OF•44g11
KND Engineering, Inc.Dates: 1 st 6/04/04
s * .•9
149TH i
Inspections performed by:
..�• � �• S'�
2nd 6/04/04
. see ... .... .......
Developme t Services Department Approval 3.-A i ojw11aN
;� KennCEfi�M,16
Reviewed and approved by: Gf/ Date: J�/8 �Z
,�
,�FppgOESI
DNP+air
AS—BUILT SYSTEM DETAILS/SITE PLAN Permit SW040157
BIRCH TREE ESTATES, B1, L5 PID# 017-141-46
�L
O
o EXIST NG
K(�D ��z 3 B RM'
}I, ,
7'
, H SE
b A
n G� FCO
KND TH—GROUNDWATER
MONITORING TUBE
A—C=91'
B—C=94'
x
n<v
500 GAL G
STEP
C
�OFo I H*
F4
KENNETH W. D CE 711 8 4F
jor
��sstoll�� �►
1
1250 GALLON
TANK
EXISTING 500 GALLON
UFT STATION
FINAL GRADE
PREPARED FOR:
RANDI UHART
5200 RIVERTON
ANCHORAGE, AK 99516
344-6770
FIELD BOOKS couw7m:
oouw R . DRAM:
STAK94 *CC M- Kb
DWI FLE OR&. 3r
SCALE: 11' - 30'
SEWER ROCK 99.6 •F
99.19 —r •i -
SAND
04037
SCALE: NTS B919 "
M4 ll 1W ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
MUNICIPALITY OF ANCHORAGE m
Development Services Department ' `to
On -Site Water & Wastewater Program
4700 South Bragaw Street I�O� N O o VL
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: May 28, 2004
Expiration Date: May 28, 2005
Permit Number: SW040157 Parcel ID: 017-141-46
Legal Description: 1WRCTREE'ESTATESBLK-1 _LT -5-r
Design Engineer: 0070 KND Engineering Site Address: 005200 RIVERTON AVE
Owner Name: Randi Uhart Lot Size: 27856 SQ. FT.
Owner Address: 5200 RIVERTON DRIVE Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE, AK 99516-4230
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Date:
1
Issued By: f � Date: 7y o
i it
Municipality of Anchorage
Development Services Department
Building Safety Division y
On -Site Water and Wastewater Program
64
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 01 7 - 1y I - '/6 Permit Number SW
Property owner(s) Randi tlhart
Day phone 344-6770
Mailing address (1) 5200 Riverton, Anchorage,
AK Q9516
Mailing address (2)
Zip Code
Legal description (Lot, Block & Sub'da
Birch
Tree Fstates, Block 1, Lot 5
Legal description (Section, Township & Range)
Lot Size z -I-, 8 Sb Acres/Sq.Ft.
Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only
❑
Well Only
❑
Sewer and Well
❑
Water Storage
❑
Sewer Upgrade
21
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jacuzzi
❑
Swimming Pool
❑
Water Softening Unit
❑
Therapy Pool
❑
I certify that the above information Is correct. I further certify that this application Is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
of property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number: Z IN
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
KNIDD ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8
(907)696-8111
May 24, 2004
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Sewer Upgrade — Birch Tree Estates, Block 1, Lot 5
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit to upgrade and
replace the existing septic system and tank for the subject lot. Due to well radii, shallow
groundwater and surface water, the existing septic field is located in the last remaining
location for an absorption system. Per previous discussion with DSD staff, we propose
that the existing system's bio -mat saturated soils to be removed and properly disposed
of in accordance with municipal standards and clean material reinstalled per the
attached design. On May 14, 2004 one groundwater monitoring test hole was
performed to verify groundwater—which was noted and monitored at a depth greater
than 6'.
We have designed our system utilizing the existing test hole performed by S&S
Engineering. The lot is served by an individual well. We propose to install a 10' wide
bed. The general slope of this lot is from cast to west at a grade of approximately 3 —
8%.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100' of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system. If you have any questions, please
contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
IKHD Engineering, Inc.
Duffus, P.E.
Attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Owner/ Contractor Specs
WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN
BIRCH TREE ESTATES, BLOCK 1, LOT 5
13.00
143.00 °""�'"° 143.00
o�
EXIS G
�£ 38 M
KD
9t H SE
'O4
CV
I(j
Irn aMEaN
n0 TN+I
O1
° ` �
a°sTla ADD a•IEo1l
Irr euro,
NT �
T TNNlcW OOaM YIP
"DIG 140 IIE WOA 11.,0, t{ Q OI WMZ
• vWvaTr 4Cs �
/w011 A C00S01UCro1 r
M02 CO"Q �/ ILL
1NMNx YIP /Old•t
6O INOWdNOWlP
143.00
145. 0 143.00
00
160.00ff
160.00
Esmt
SYSTEM PREP NOTES:
PRESSURIZED DISTRIBUTION SYSTEM HOLE SPACING DESIGN
1. RESIDUAL HEAD - 5'
EXCAVATEI5' x 70' AREA TO A
2. HOLE SIZE - 3/16' - 1.00 GAL PER HOLE O 30 PSI
DEPTH OF 4' & REMOVING ANY
3. 30 GALS (PUMP DELIVERY)/1.00 GALS./HOLE — 30 HOLES
BIO—MAT SATURATED SOILS.
4. 130 LF LATERAL/30 HOLES - 4.3' SPACING PER HOLE
INSTALL 3' OF SAND & LEVEL.
5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS.
THEN PROCEED WITH INSTAL
DESIGN DETAILS
OF 0.5' ROCK, ... PER DESIGN DETAIL 3BDRM X 150 GPD - 450 CPD
450 CPO/0.7 GPD PER SQ. FT. a 643 SO. FT
(643 SF / 10' W) - 65 FT. BED
Total depth of system Is 1' from existing grade.
NO PUBLIC WELLS MMI 200' OF
Total depth of gravel below distribution pipe is 0.5 .
PROPOSED SYSTEM.
"POSEnLLuAS OF
NOTES:
PnRODsTEM TNOTED.
No SEPTIC SYSTEMS wTNN ear OF
1. INSPECT EXISTING TANKS & REPLACE IF NECESSARY
PROPOSED WELL EXCEPT AS NOTED.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM..
3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
44
PREPARED FOR:
1
�
RANDI UHART
5200 RIVERTON
*
ANCHORAGE, AK 99516
/
Scale: 1"= 60'
4-�`ke44'
344-6770
/
FIELD BOOKS CCIIPUTM
ENGINEERING
WDNO•R DRAWN:JG
Ya
�
4 X
BOUN A
srAxNa STAKING O1EQ'ED' KMD 20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
A T. DATE 5/24/04
.�
:--..... ::::::....... ................... I...............
M as CRo, 3037
'`CND TIE FILE '°B "°: 04037 (907)696-6111/FAX (907)696-8111
WASTEWATER DISPOSAL SYSTEM
DETAILS
BIRCH TREE ESTATES, BLOCK 1,
LOT 5
D
o
)
EXIST NG
3 B RM
H 0 SE
o �
U G
N
FCO
6 0
0
N 1250 GALLON
SEPTIC TANK
L1
DBL2
70.8' 0
EXISTING 500 GALLON
LIFT STATION
MT o
MH
�-
�
MT
NOTE: FLAG
ALL WELL RADII
&
PRIOR
PROPERTY LINES
TO CONSTRUCTION
MT O
/
NOTE: COVER W/ FILL
SURFACE WATER PONDING
KIND TH-GROUNDWATER
j �'qi OF
PREPARED FOR:
/ (� 9
RANDI UHART
5200 RIVERTON
ANCHORAGE, AK 99516
3446770
Scale: 1"= 20'
PAGE 2 OF 2
rFlan
CE -7 l �,,� o
�? /
e'w
BOOKS Cawrzu:
ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
. N DRAM: JG
B*�STA"'Q c STAKING ocaau: KMD
"Beak ASB I T DAI ' 5/24/04
errl fxL an: 3037
IE---. . - -
907 696-6111/FAX (907)696-8111
ACAO"FILE JOBr , 04037
KND ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
696.6111/FAX (907) 696-8111
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES AND MATERIAL SPECIFICATIONS
LEGAL DESCRIPTION: BIRCII TREE ESTATES, BLOCK 1, LOT 5
GENERAL:
1. The scope of this project includes the installation of a septic tank and/or drainfield to serve a
single famil residence on the referenced property as delineated on the attached Municipality of
Anchorage MOA) permit and site plan.
2. Construction shall be in accordance with the approved site plan and design drawings; MOA
permit with any special provisions or conditions, and all applicable State and Municipal
Wastewater Disposal Regulations.
3. KND Engineering Inc (KND) assumes no responsibility of the accuraty of the as -built survey
provided by the owner or owner's representative.
4. The owner or contractor is responsible to notify the engineer of any discrepancies noted on the
design plans or drawings prior to commencing work. These discrepancies could be, but not
limited to, possible encroachments, surface water, varying soils, unplatted easements, types or
use of dwellings on or adjacent to property, nearby public wells, etc.
5. The contractor shall be responsible for locating any necessary underground utilities, easements,
property lines and surface water. The owner and/or contractor shall ensure, if deemed
appropriate, that a registered land surveyor prior to construction flags all setbacks.
6. The contractor shall be responsible for verifying all pertinent separation distances and
component layout.
7. Unless specifically agreed otherwise, the property owner shall be responsible for final grading
areas subsequently depressed from soil settling. On all leachfield mound systems, the property
owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded
area.
8. The MOA Development Services Department On -Site Water & Wastewater Program must
certify contractors installing wastewater disposal systems. Owners installing their own systems
must also receive prior approval from said MOA Department.
SEPTIC TANK / HOLDING TANK / LIFT STATION INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall
include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded with proper material and compacting to prevent
damaging, settling or shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches above the final grade.
4. Septic tanks installed with less than 4 foot of cover shall be insulated. The contractor will
ensure that the fill over the tank does not exceed the burial depth rating.
5. A foundation cleanout shall be installed one to four feet from the building foundation. In the
line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent
pumping system exists within the septic tank). These cleanouts shall be located on undisturbed
soil not more than 10 feet from the tank. The second cleanout, in line, shall be to clean toward
the septic tank.
6. Final grading over the septic tank shall be such that a positive slope exists away from the septic
tank.
Reference: BIRCH TREE EST 61, L5
Date: 05/24/04
Page: 2 of 3
7. All H.D.P.E. tanks shall have a vertical length of 4 -inch perforated drainpipe besides the tank
extending to the bottom of the tank to above grade to monitor ground water.
8. All tanks shall be anchored when there is not enough adequate soil cover to resist buoyancy
forces in high -groundwater areas.
9. All holding tanks and lift stations shall have an audible and visual alarm inside the residence.
10. All lift stations shall be wired in compliance with the Uniform Electrical Code and all MOA
guidelines.
11. The contractor shall remove the old tank, or abandon it in compliance with the Uniform
Plumbing Code. The contractor is solely responsible for the abandonment procedure.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavaction become smeared,
they must be raked or scratched (roughed -up) before gravel (sewer rock) placement.
2. Once the sewer rock is installed, the distribution pipe is installed level with the perforations
facing downward. Gravel is then to be placed over the distribution pipe to provide a minimum
of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure
the silt barrier covers the entire gravel surface before placing backfill.
4. Monitoring tubes shall be four- (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. The portion of the
monitoring tube extending through the gravel shall be perforated from the bottom of the trench
to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as
noted on the design.
5. Backfill over the final gravel layer must not be less than twenty-four inches. Insulation must be
installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the
trench must be mounded to prevent the formation of a depression after settling.
6. All advanced technology waste water disposal systems (Advantex, Biocycle, Intermittent
Dosing Sand Filter, etc...) shall be constructed, installed, maintained and monitored per
manufacturer's specifications and MOA requirements.
MINIMUM MATERIAL SPECIFICATIONS:
1. A MOA approved septic tank manufacturer must construct any septic tank proposed for
installation.
2. The following pipe materials are MOA approved for use in septic system installations:
Tyne of Pipe Perforate EMU
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company
Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or
equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between
the final leachfield gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing
the 8200 sieve. If deemed necessary, a sieve analysis should be performed.
7. When sand is being used as a filter material, its gradation specification must conform to current
MOA or DEC requirements.
Reference: BIRCH TREE EST B1, LS
Date: 05/24/04
Page: 3 of 3
INSPECTIONS:
Typically there will be three (3) inspections required during the installation of the wastewater
disposal system. These inspections will occur as follows:
1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds
and before the installation of any gravel. A septic tank may be set in place, but may not be
backfilled before this inspection.
2. The second inspection must be conducted after the placement of the sewer rock, distribution
lines, standpipes, and cleanouts, but before the placement of the silt barrier, insulation, or any
other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required, especially with the installation of multiple
trenches, sand filters, pressurized distribution systems, etc. The inspecting engineer is to be contacted
at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take
place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's
activities.
The owner shall contract with the contractor to perform the work outlined in these specifications and
attached plans and in accordance with the attached MOA permit. All materials, components, and
construction practices shall comply with the MOA's and the State of Alaska's latest ordinances,
regulations, or policies regarding wells and septic systems. The failure of the inspecting engineer to
notice a material or construction non-compliance does not relieve the contractor of his/her
responsibility to correct such deficiency. There will be no contractual arrangement existing between
the contractor and KND Engineering, Inc. KND shall be the owner's representative and will inspect the
work as stated above to document the contractor's activities. Final acceptance of the contractor's work
rests with the owner and the MOA.
KND shall have no liability to the owner or to others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the contractor to carry out the work in
accordance with these construction documents. KND's inspecting engineer will not be responsible for
the construction means, methods, and techniques, sequence, procedures or the safety precautions
incident to this project.
BY PROCEEDING FORWARD WITH THE INSTALLATION OF THE WATER AND/OR
WASTEWATER SYSTEM (S), THE PROPERTY OWNER, CONTRACTOR, AND WELL DRILLER
ACKNOWLEDGES HAVING READ AND ACCEPTED THESE SPECIFICATIONS.
Municipality of Anchorage Page of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SeJ y PID Number: 00-/yl' Y6
Name:
e��a
,L /�c✓�CC c�/e%/�'� /LL
Wastewater System: El New 9 Upgrade
Address:
ABSORPTION FIELD
Phone:
s- �9,2
No. of Bedrooms:
❑ Deep Trench I&Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
J
GPD/Sq. Ft.
I
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
�l Qc J_ r C' % ES
5 Ft.
Ft.
Township:
Range: _
Section:
Fill added above original grade:
Gravel length: //--
& (
Ft.
Ft.
�)Q/S (� ew ❑ Upgrade
Gravel width:
Number of lines:
Distance between lines:
Ft.
Ft.
Classification (Private, Total Depth:
Cased To:
Total abs or tion area:
Pipe material: It
Ft.
Ft.
SQ. Ft.
S F 14 4 /0V <—/ - O
Driller: Drilled:
Static Water Level:
Installer:
Date installed:
Ft.
X C
Yield:
Pump Set at:
Casing Hei bove Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
❑ Septic ❑ Holding IXS.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
A/iGAde. j 1
Wei Fr
__
Material:
Number of Compartments:
/oo/
/oo�
Ad
s - ` L
Surface
—
LIFT STATION
Water
H/
Loti
Line
.�
y
.3
Jam&'
Size in gallons:
Soo
Manufacturer:
A),c4oRA^6/C
Foundation
��'
6 3/
a� i
"Pump on" at:
"Pump o " level at:
High water alarm at:
Curtain
,11_-(aPump
Make & Model
Electrical Inspections performed by:
Drain
I
do cis/ osl�l�
nye. n. A.
Remarks: ]F,w, S r/NG' T A4- C y COmPo tr/3r-y
BENCH MARK
Location and Description:
A 3 A� 130,v 4-Q +iw oleo,# cN 0F0 �,�, ,, vA l�Ar�r+ �.
%rJ� M = % is A' L
WK}rurc/L v�EGt�� s TE.� i�rw ff,E✓ LkoJc/ll���L�
L/a
Assumed Elevation:
T�•i. c H ANN W4.fr Pev,j ofA y
/p
L
, tl ,....,..A
,.. •., S
S 1, S SMGINEERING
t
Inspections performed by: 17034 Eagle River Loop Road N b : 1stCagle
.......... ,....
River, A-a: a
2nd 0-09 &
........ ,.<.........
ROBERT C. COWAN
z,� (o-/ k 8
�0`�v�s•ti CE-8801
ili;ZF
Department of Heal and uman Services approval
�,w• ..,.•,,,,,.^,,;;; ;�
�ti�•��..11i��
Reviewed and approved by: Dater
72-013 (Rev. 9/91) MOA 25
PERMIT NO. SW980164
PAGE 2 OF 3
Municipalit of Anchora e
DEPARTMENT OF HEATH AND HUNI�AN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Tele hone; 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WWELL INSPECTION REPORT
LEGAL LOT 5, BLOCK 1. BIRCH TREE ESTATES P.I.D. NO. 017-141-46
RIVERT❑N \AVEN
is a
BTI a
EXISTING 1230 GAL
L ❑ T 4
BL1 SEPTIC TA NK
---�
�
DBL2 873
NEV 500 GAL
LIFT STATION
_ -cl
i --------� MT]
YN
I I
LOT
��NEV
TRENCH
L ❑ T 5
L 9 MT2
SCALE 1^ = 40'
''.� Q p1w
—
— — —
10' UTILITY EASEMENT
�,•+'•�• •'••,,�5�
4
LOT 14
�
gG�
LOT 13
,
�,,,
M1• •... .. !'I.•.•• •MA•��tt•
ROBERT C. COWAN �< j
CE - 8801
`iZ ,may„•..
•,+"
PERMIT N0. SW9801 64 PAGE 3 OF 3
DEPARTMENT OF ANDhHIJKAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 5, BLOCK 1, BIRCH TREE ESTATES P.I.D. NO. 017-141-46
A B
ST3
60.5 29.5
MH
62.5 30
MT1
74.5 68.5
ST3
MT2
1 19 1 13.5
99' FINAL GRADE
DBL1
52 27.5
DBL2
52.5 28
MH
ST 1
43.5 20.5
ST2
49.5 25.5
FCO
31 24
NEW
95.0 500 GAL
S.T.E.P. 9 N •°I'
SYSTEM
FINAL GRADE MT MT1 = 100.8
MT2
`MT2 = 100.5'
INSULATION
SR 98.3
MT1 = 97.2'-/'0/
MT2 = 97.2'
SCALE I"" - 40'
WATER FOUND 93.2'
C'C�; '"� A~'••.,`�r
89.7' B.O.H.
,v � ••��
z
49]t.w• - •nM•�•r war
l ROBERT C. COWAN
CE .8801 ,• ,r
' yl
ry,
JUN -23-98 TUE 09:47 HEA1r'ENL '' XLgCT,_GOi 373 3894
+ A03 le tit 29
`�'II)j�1 't1'A1.I'�" [�I�' �%CY�; I©� A► ' . �,. X.7 ,1� �� 1+� +xv )MVISION
35500 yAgr TUDOR ROAD, ANCHORAGL, AJ AISKA .
IN.UTCHO�`�•S': Yeace: (x'97) 563.;3464 Fe (00) 03=0. 35 I F'()RUMON.' (90434-1-8211
vrr�.Y x,�t��rrs rc.�:c rtticA�r _ ._..�..�__.. w...,�...._._-.-.- p���r���.�rtre���r�
4WA ILEA X).616: (W27i93 05.30M
AI,PDJ?KS,": 4200I3.I rM TON AVE
_ 1'l10,'Vtt fiX: , 24�-����7
t.0 :"..5....._._.._.__..,._.--iZl�.OG' :..A ."._.,,".. _..w.._.SU IIx�'ISIO.'Y• 1311�C;fI JURE, ;STATES ....__..
I,jp T+STATK)N-OARAGF, IS OPEN RMS% LARGE GAR."40E Vf_'►[?R II;:'I1 RZ.9
t.ta.fA.l1�NI VACANT _ .�_�.,..�....... _ . .....
�';E' . Ole FXvtsical Route tnrr.���! ljC:w�c C1
.'to noel w.% iphatce nhsemed.
t�ii!1 re-er�lzuna at »Tact irea{aacdcm. (.j [)a not cmccfl tm;i4 re-jmp, ao& l.. j C.l".ci-��,prcn tevt�lt�r. ►r� b�:tn�,7).
C:r���aatts.11d`is': '..._.__.... �.............�__f....._..._.,_.........._......_...._..,.... . •-- __—_—..._T— SX'Alt's"ItMi?: _..... ,.,........
PURVOTONREVORT
P.@1
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ti
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00 N07'RA',3xOVF' IVIS MO7iCE ",a
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Permit Number: SW980164
Design Engineer: S & S Engineering
Owner Name: Lawrence Cartmill
Owner Address: 5200 RIVERTON DRIVE
ANCHORAGE , AK 99516-4230
Upgrade
1
Lt)o LO - �1
Date Issued: Jun 11, 1998
Expiration Date: Jun 11, 1999
Parcel ID: 017-141-46
Legal Description: BIRCH TREE ESTATES BLK 1 LT 5
Site Address: 005200 RIVERTON AVE
Lot Size: 27856 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
Disposal Field [,/7 Septic Tank E, Holding Tank Privy Private Well Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: —4& 7— 6 <�'
Date:
Issued By:
P4_P�
tV l a,_ C Date: `�
S&S1
pneCRInG ROBERT C. COWAN, P.E.
CIVIL ENGINEERS
7ALAM (907) 694-2979
7 May 26, 1998 FAX (907) 694-1211
HEALTH AUTHORITY
APPROVALS
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
SEWER&WATER
Anchorage, AK. 99519
MAIN EXTENSIONS
REFERENCE: Lot 5, Block 1, Birch Tree Estates
SEWER & WATER
INSPECTION
Request you issue a permit to install a septic system upgrade to serve the proposed
three bedroom house on the referenced property.
ENGINEERING STUDIES
One test hole was excavated and a percolation test performed. The approximate
AND REPORTS
location of the test hole is located on the attached site plan.
r
At the time of excavation 5/9/98, water was encountered in the test hole After seven
WELLINSPECTION
days ground water monitoring the monitoring tube was checked and the hole was found
& FLOW TEST
to be at 6.5 feet.
We do not anticipate any adverse effects on neighboring wells, septic systems or
SITE PLANS
drainage patterns by the installation of the proposed septic system
There are no points of contamination within the proposed well radius that can be seen
on the attached site plan.
ROAD DESIGN
If you require additional information, please contact us.
SOIL TEST
Sincerely,
9a174 ----
PERCOLATION
TEST
Robert C. Cowan, P.E.
RCC/mg
STRUCTURAL &
Enclosure
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
1 " = 40' DESIGN
DETAILS
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Municipality of Anchorage . ,,�"•• .�. ••'•��'f
•
DEPARTMENT OF HEALTH &HUMAN SERVICES ,,'.F•.• .� .E V "`1 ��»� •� p
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TESTj
ROBERT C. COWAN f ,,k-
PERFORMED FOR: L4 W 9t, c & C4 �t' T lti►1 L < DATE PERFORMEI)i �;
LEGAL DESCRIPTION: 2C (-� %R� S ria Y� Township, Range, Section:
DEPTH SLOPE SITE PLAN
2
3
4-
5-
5
6
7
8
9
(FE�)
/6 "k rk 54-6 s L'r
Net
Drop
ft�is 5K
/j
/a
/
o�
3
-
•�.a
• 6-
11
12
13
14
15
16
17
18
19
"``` � `© WAS GROUND WATER
ENCOUNTERED?
/ S
IF YES, AT WHATLO
DEPTH? P
E
Depth to Water After p / `�J/�% g
Monitoring? G �� Date:
0
Reading Date
Gross
Time
Net Depth to
Time Water
Net
Drop
ft�is 5K
3
20 t__j - PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN a 'l FT AND FT
COMMENTS
PERFORMED BY: S & S ENGINEERING d4
CERTIFY TH T THIS TEST WAS PERFORMED IN
17034 Eagle River o S
ACCORDANCE WITH §-ffiWV)ft'tlIr711If 9AX7GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
sW
;ineexinG
ROBERT C. COWAN, P.E.
ON-SITE WASTEWATER DISPOSAL SYSTEM RM.CIVIL ENGINEERS
ALAM CONSTRUCTION PRACTICES FAX(694-29
� FAX (907) 694-4-
1211
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 5, Block 1, Birch Tree Estates Subdivision
May 26, 1998
GENERAL:
1. The scope of this project includes the installation of one pressurized trench and an 500
gallon S.T.E.P. tank to serve the proposed three bedroom residence located on the
referenced property. The existing 1250 gallon septic tank is less than two years old and
will remain in place.
2. Construction shall be in accordance with the approved site plan and design drawings,
Municipal permit with any special provisions or conditions, and all applicable State and
Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any necessary underground utility
locates.
4. Unless specifically agreed otherwise, the property owner shall be responsible for final
grading areas subsequently depressed from soil settling.
5. Contractors installing wastewater disposal systems must be certified by the Municipal
Health Department for system installations. Owners installing their own systems must
also receive prior approval from the Municipal Health Department.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction
shall include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches above final
grade.
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
5. A foundation cleanout shall be installed one to four feet from the building foundation.
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page 2
Lot 5, Block 1, Birch Tree Estates Subdivision
May 26, 1998
6. Final grading over the septic tank shall be such that a positive slope exists away from
the septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on the design. The bottom of
the excavation shall be within 2 inches of level. If the sidewalls of the excavation
become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock)
placement.
2. Once the gravel is installed, the distribution pipe is to be installed level with the holes
faced downward. The distribution piping is to be of PVC (ASTM D3034 or equal). All
joints are to be solvent cemented. Gravel is then to be placed over the distribution pipe
to provide a minimum of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel layer and the native soil backfill.
Ensure the silt barrier covers the entire gravel surface before placing backfill.
4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the
locations shown on the design, and extend a minimum of 12 inches above final grade.
The portion of the monitoring tube extending through the gravel shall be perforated
from the bottom of the trench to the invert of the distribution pipe. This is equivalent to
the effective depth of the gravel as noted on the design.
Backfill over the final gravel layer must not be less than twenty-four (24) inches.
Insulation must be installed when the backfill depth is less than thirty-six (36) inches.
The finish grade over the trench must be mounded to prevent the formation of a
depression after settling.
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be constructed by a Municipally
approved septic tank manufacturer.
Page 3
Lot 5, Block 1, Birch Tree Estates Subdivision
May 26, 1998
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Tyne of Pipe Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the inspecting
engineer.
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical
Company Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femeo,
or equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed
between the final leachfield gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3%
passing the #200 sieve.
7. When sand is being used as a filter material, its gradation specifications must conform
to current M.O.A. or D.E.C. requirements, which ever specifications applies.
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the installation of
the wastewater disposal system. These inspections will occur as follows:
1. The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any gravel. A septic tank may be
set in place, but may not be backfilled before this inspection.
2. The second inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, standpipes, cleanouts, and insulation, but before the
placement of any other backfill.
3. The final inspection is to occur upon final grading of the property.
Page 4
Lot 5, Block 1, Birch Tree Estates Subdivision
May 26, 1998
Often there will be more than these 3 inspections required. Especially with the installation of
multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting
engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a
pre -construction meeting will take place on-site. The inspecting engineer will not coordinate,
direct or control in any way the contractors activities.
The owner shall contract with the contractor to perform the work outlined in these
specifications and plans and in accordance with the attached M.O.A. permit. There will be no
contractual arrangement existing between the contractor and S & S Engineering. S & S
Engineering shall be the owner's representative and will inspect the work as stated above to
document the contractors activities. Final acceptance of the contractors work rests with the
owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor
to carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR/INSTALLER
Municipality of Anchorage Page i 0t Z
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 •Anchorage, Alaska 99519-6650 ® Telephone: 343-4744
On -Site Wastewate Disposal System and/or Well Inspection Report
Permit Number: N PID Number: �('7 ~ 141-46--0
Name:
Wastewater System: O New 0 Upgrade
Address: gCtti��
57-00 � �v �ZTa.�% Com t�-'`T",
ABSORPTION FIELD
Phone:No.
34-,5 _ oA4
of Be rooms:
D Deep ch ❑ Shallow Trench []Bed ElMoun ❑ other
LEGAL DESCRIPTION
Soil Rating:
��PD/Sq.
Total Depth fro riginal grade:
Ft.
Lot: Block: Subdiv�isioon:C
Depth to pipe bottom from origins ede:
Grave epth beneath pipe
Ft.
Township:
Range:
Section: ,
Fill added above original grade:
ravel length:
Ft.
Ft.
L• NewUpgrade
WEIZFt.
Gravel width:
Number ines:
Distance between lines:
Ft
Classification ate, A,B,C): Total Depth:
C o:
Total absorption a:
Pipe material:
Ft.
SQ. Ft.
Driller: D rilled:
Static Water Level:
Install
Date installed:
Ft.
Yield: P at at: Casing Height Above Ground:
TANK
Ft, Ft.
EPARATION DISTANC
�/ Septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Llft
Holding
Public/Private
Manufacturer: )
V N V I�1 t7i'-� N
Capacity in gallons:
i Z-�'
From
Tank
Field
Station
Tank
Sewer Lines
Well-
101—+ �
N
� �>�
Material:
Number of Compartments:
LIFT STATION
WateSurface
Lot
/
Size in gallons: Ma urer:
Line's
"Pump on" level at: "P " Is High water alarm at:
Foundation
�l' jt
Curtain
Pump Ma odes
Electrical Inspections performed by:
Drain
BENCH MARK
Remarks:
`�f 1i!- tvA ©21C�1N PrVSTA-rt
Location and Description: ��
�z pLoc)f' ( 16N -
w tu.-r A tT 1 rJ
2 ,
Assumed Elevation:
too' c)(-)
Ft
ElPNEFR'S S
.w
`.� OF 44'
�........ {
r -7 +d0
Inspections performed by: S Dates: 1st
2nd
• • .. ... "...• . `�
RC I J e A. ernes« W „0
Department of Hea h and u n rvices appr Val
0.4
�4.. E-7953 •���
4i��9.,ej.••...a•" 0. ..1
Date:
Reviewed and approved b :
72-013 (Rev. 9/91) MOA 25
kl� —QL4 cL.; D L -j (-ff —.
RIVERTON COOURT
•
WELL
DISTANCE FROM EDGE OF WELL TO
CENTER OF FIRST TANK C/O = 103.2 FEET.
Z/Z
1. 1250 GALLON SEPTIC TANK INSTALLED ON 4/9/92.
2. INLET INVERT=96.2
3. OUTLET INVERT=96.1
4. TANK SET LEVEL WITHIN .8 INCHES.
5, 4 INCHES OF INSULATION BOARD OVER THE TANK, PLACED 8/27/96.
6. GROUND OVER TANK = 99.6 (APPROX.). COVER = 2.7 FEET.
7. SEWER LINE FROM TANK TO TRENCH HAS A SLIGHT REVERSE GRADE.
APPROXIMATELY 1/2 INCH RISE. SHOULD NOT EFFECT SYSTEM.
B. TANK IS LOCATED IN DRIVEWAY.
SOUTH PROPERTY LINE
SEPTIC AS-BUILTi LOT 5, BK 1, BIRCH TREE ESTATES S/D,
PREPARED FOR+ LYNN ROBERTS
PREPARED BY, ALASKA WATER & WASTEWATER SERVICES
DATE, 8/27/96 DRAWNi GARNESS SCALE, 1' = 30'
ab OF AC ,
or
f Fs Jef y A. Garness
E-7953
�. .• C
do
t����pROFESS0�P�.""
LOT 4, SK 1
BIRCH TREE
FOUNDATION
ESTATES, VACANT.
C/O.
Y
o~e
a
'C'
•B'
ae
DOUBLE
a
C/O.
o
F-
v'
AC = 26.7
H
w
3
BC = 20.2
1. 1250 GALLON SEPTIC TANK INSTALLED ON 4/9/92.
2. INLET INVERT=96.2
3. OUTLET INVERT=96.1
4. TANK SET LEVEL WITHIN .8 INCHES.
5, 4 INCHES OF INSULATION BOARD OVER THE TANK, PLACED 8/27/96.
6. GROUND OVER TANK = 99.6 (APPROX.). COVER = 2.7 FEET.
7. SEWER LINE FROM TANK TO TRENCH HAS A SLIGHT REVERSE GRADE.
APPROXIMATELY 1/2 INCH RISE. SHOULD NOT EFFECT SYSTEM.
B. TANK IS LOCATED IN DRIVEWAY.
SOUTH PROPERTY LINE
SEPTIC AS-BUILTi LOT 5, BK 1, BIRCH TREE ESTATES S/D,
PREPARED FOR+ LYNN ROBERTS
PREPARED BY, ALASKA WATER & WASTEWATER SERVICES
DATE, 8/27/96 DRAWNi GARNESS SCALE, 1' = 30'
ab OF AC ,
or
f Fs Jef y A. Garness
E-7953
�. .• C
do
t����pROFESS0�P�.""
Alaska Water & Wastewater
8471 Brookridge Drive — Anchorage — Alaska 99504
Phone (907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
July 30, 1996
Municipality of Anchorage
Dept. Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O Box 196650
Anchorage, Alaska 99519-6650
Ref: HAA for Lot 5, Block 1, Birch Tree Estates S/D.
To whom it may concern:
• H
. Ja ey A. Garness
CE -7953 ��00
'PROFESS`a ��.�low
The subject property has a 3 bedroom house which is served by a private well & septic system.
Comments regarding the well and septic are as follows:
WELL: The well was tested on 7/20/96. The static level was 97 feet. Water was pumped at a
rate of 4.87 gpm for a total of 93 minutes (453 gallons). The water level in the casing dropped
38 feet, during the initial 45 minutes, and stabilized thereafter at 135 feet. Upon completion of
the pumping period, the level recovered to 104 feet in 60 minutes, and recovered completely in
approximately 2 hours. Based upon this data, the well was deemed to be adequate for a 3
bedroom house.
SEPTIC SYSTEM: The septic system was initially inspected on 6/27/96, and found to be in a
surcharged condition, with thick black solids in the sump. The homeowner retained Issac's
Pumping to jet clean all of the lines. I reinspected the trench on 7/19/96, and found the pipes to
be clean, and the liquid level in the sumps to be in the normal operating range. I attempted to run
the adequacy test on 7/20/96, however, it did not recover quickly enough for me to monitor the
absorption rate, before the residents returned (and began using water). I retested the septic
system on 7/29/96. The results are summarized as follows:
Prior to starting the adequacy test the water level in the monitoring tube was 26.75 inches. Water
was introduced at 4.12 gpm, for a total of 230 minutes (948gallons) the water level in the
monitoring tube rose 14.25 inches, to a total depth of 41 inches. This corresponds to 66.5
gallons/inch. The water level was monitored 24 hours later, and it had dropped to 31 inches, a
recovery of 665 gallons. Based upon this data, the trench was deemed to be adequate for a 3
bedroom house (450 gallons per day).
NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not
limited to, seasonal surface water infiltration, groundwater variations, septic system
maintenance (frequency of septic tank pumping, usage of biological additives), condition of
drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age),
type of substances deposited in septic system (cigarette butts, sanitary napkins, misc. objects),
and the amount of water being introduced on a continual basis. Consequently, the results of this
adequacy test are only valid for the specific day of the test. Furthermore, because of the limited
nature of this investigation, it is possible that there are hidden defects which may not have been
detected. No warrantee is made regarding the future performance of this septic system
DRAINFIELD IS UNDERSIZED BY 3 PERCENT: According to the inspection report, dated
8/27/84, the drainfield is a 5 foot wide trench, 47 feet long, with an effective depth of 3.5 feet. If
this is correct, given a reduction factor of .54 (for 3.5 foot effective depth), the total absorption
area is 436 square feet. Since the soil rating is 150 square feet per bedroom, the minimum
trench area, for a 3 bedroom house, is 450 square feet. In short, if my calculations are correct,
the trench is undersized by 3.1 percent, or about 3 feet. In my opinion, the benefit of adding this
minimal length is so insignificant, that it is not justified, particularly since the absorption capacity
of the trench is approximately 665 gallons/day at this time. Please provide direction from your
department.
UNDOCUMENTED SEPTIC TANK: In April of 1992 the original septic tank (installed in
1972) was replaced by C & V Backhoe Services. This tank was installed without a sewer permit.
The homeowner, Mr. Lynn Roberts, was unaware of the permit requirement. Attached is a copy
of the contract that Mr. Roberts had with C & V Backhoe. Per the documentation a 1250 gallon
tank was installed. In addition, the contractor installed a foundation clean-out, and a clean-out
after the tank, which sweeps towards the trench. The new tank, like the old one, is in the
driveway. The tank is buried about 2.5 feet (ground to tank lid) below grade. Mr. Robert's can't
remember whether it was insulated or not, but indicated that it has never froze -up.
According to Mr. Robert's, prior to replacing the tank, they had several sewer back-ups, and,
since the installation of the new tank, have had no further problems. I noted dry toilet paper, just
below ground elevation, in the foundation clean-out (installed 1992). This is an indication that
the system has operated in a severly surcharged condition, sometime since the foundation
clean-out was installed. Given the condition of the piping, prior to the jet cleaning, it is not
suprising that the system has backed -up in the piping. Now that the piping has been cleaned, and
the system is operating in the effective drainrock depth, ideally this surcharged condition will not
reoccur.
CLOSING: If you have any questions, please contact me at 337-6179, or on my digital pager at
1-800-481-1162. Thank you for your assistance.
Sincerely,
P.E., M.S.
c.c. RE/Max Properties, Tim Rittal
Lynn Roberts3wps
K.
ME Environmental Services Inc.
Ade hk Laboratory Division ,.aiw,�•,�►.w.►�.�,res,►i,,.iiiiiri,�whiri.�.w,.nwrssiiiwi►iwr.�.
CT&E Ref.# 963100.963100002
Client Sample ID 5200 Riverton Dr.
200 W. Potter Drive
Anchorage, AK 99518-1605
Tel: (907) 562-2343
Fax: (907) 561-5301
Collected Date 07/19/96
Matrix Drinking Water Technical Director: Stephen C. Ede
PWSID 0 Released By
Sample Remarks:
Parameter Results QC PQL Units Method Allowable Prep Analysis Init
Qual Limits Date Date _
Nitrate -N 0.100 U 0.100 mg/L EPA 353.2 07/23/96 EMB
Total Coliform 0 0 col/100mL SM18 9222B 07/19/96 TAV
U Undetected
LT - Less than
GT - Greater than
D Secondary Dilution
J Below the calibration range
.n
(2) GS Member of the SGS Group (Soci6t6 G6nkale de Surveillance)
ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA
P.G. roX �.,....
-71';6
�U%
CITY, STATE AND CODE
ARCHITECT
DATE OF PLANS
ar; ,' , of Pages
PROPOSAL
5 , A
r i .• '4 /
JOB NAMEk'
JOB LOCATION' { !'
IJOB PHONE
We Propose hereby to/m material and I�bor — c Tete i cordance with above specifications, for the sum of.,
Payment to be mad as follows
Ali material is git,3ranteox1 to be as specified. All work to be completed In a substantial workmanlike
manner acconiirg to specilicadans submitted per standard practices Any alteration or deviation from
above sixncificatio ns involving extra costs wNl be executed only upon written orders, and will became
an extra ctarra over and abov,: the estimate AN agreements contingent upon strikes, accidents or
delays beyond our control. Owner to :.arry Bre, tornado and other necessary Insurance. Our workers
are fully coverall by wokman's Co nloensatlan insurance.
Acceptance f Proposal- The above prices, specifications
and conditions are satisfac y and are hereby-acceltod. You are authorized to do
the work as verified. Payr et76 will be made! as o tlintd above. N
Date of Acceptance: --
._./ .�
Agnatured
Signature Ups?:'�i%
Note: This proposal may be
withdrawn by us if not accepter} within — days.
Signature
Signature
- --
..... I ....... _.... ....... ......... ............. ...................... .--------- ..
JUL--17-1996 11:11 AURORA ENG SYS; P.01.'Qt,
P
o r
c
�v
�6� '
� 1
d�
d
AW
P711A OF 44
aw of
v
It is .the responsibility of the owns -r to determine '
am
� JQmva Karl X70 -!:
the existence of any easements, ccvLrants, or re- 'J", 1. 1564-5
Strict -ions which do not anoear.. o; the el,corded sub Q }
division plat.''�••..�-••'.
Jnder no circumstances should any �0�`
data hereon 'be used for construction or for estab- NOTE �'��.�.�M,'4•�`�
lish.inQ bo.un:dary or fence lines. The surveyor taker EASEMENTS up RECORD, OTHER THAN THOS
responsibility for the initial transaction only. SHOWN ON THE RECORDED PLAT, ARE
SHOWN HEREON.
LEGEND
LID BLOCK ORASS CAP IwaNumEMr
O IRON PIPE
.1. :~il .►� �r .PLAT NO. ) r iiEBAR PA OP.CO1i,fil0
ANCHORAGE RECORDING DISTRICT o M66 6 TACK
EPARfEQw 8Y. -
` DOWLING & ASSOCIATES
804 EAST 15 th Ave. suite 2
ANCHORAGE ALASKA 99501 REV( -5 IoM F
-r" AY: SCALE: oi - WORj<(RgDER: IrIELDS OK: 11RID: _
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
0* ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
❑ NEW
,TACK W 14 1 r Co. •- LARAY CL
6 —SSOta
;KUPGRADE
MAI LING ADDRESS
32-01 C S -r A)C. O CE . 99
LEGAL DESCRIPTION
Lot 5 SLIS ! A1RC-TREE fS?'ATE T/HM 83W S&_ 34 -
LOCATION
NO. OF_jDROOMS
o� ji
Well
Absorption area
Dwelling
PERMIT NO.
UY
DISTANCE TO:
a
Manufacturer r,,
Material
No. of compartments
Q
wF
GMS
y
Liq. capacity in gallons
IF HOMEADE:
Inside length
Width
Liquid depth
Y
10z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
YF
Manufacturer
Material
Liquid capacity in gallons
p
DISTANCE TO:
10�
Foundation ��
Nearest l�tle�
PE 1 ISO
,V50
LU
J-- W
No. of lines `
Le f.S�h line
Total lengthltitlines
Trench wi thr
Distance betwAeen lines
Z
��
FUj
Top of tile to finish grade B
5
Material beneath tile
3'5
Total effa vi a option are&!
O
inches
Length
Width
Depth
PERMIT NO.� , 9
w
0
F
Type of crib
Crib diameter
Crib depth
Total effective absorption area
CL
W°
wWell
(n
Building foundation
Nearest lot line
DISTANCE TO:
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
w
i
Building foundation
Sewer line
Septic tank
Absorption area(s)
DISTANCE T0:
OTHER
I
T�
PIPE MATERIALS
03a34 -
SOIL TEST RATING
INSTALLER
ALM 0, P R J56 5 A rt- -11
$
REMARKS
Sys -rem Alm oromp i JooI
/Ze00jjje~NT ar= �Ukd*rjoXg wEct.
/O'rRENc1 . RcwlouEo. 10fof s -W; c A MUD
4c �sr u6-
To/j 4-A 6
MnA ST cF-p
C
i
RE GW
Ald W
�
t
f APPR ED DATE/t LEGAL
wE 8�y�yg� L -S 13 ( 6"Re-14 -r4EC ESrATcs ri2,,U Lo Sac- 31+
72-013 (Rev. 3/78)
M U f� I C_ -I �" � L _. I � "^� C� IE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET $ ANCHORAGE, AK 99501
264-472G
C3 P4 _- 31 -r F_= E3E tri Er
PERMIT NO: 840550 UPGRADE
DATE ISSUED: 07/06/84 /
APPLICANT: JACK WHITE COMPANY LARRY CLARK
ADDRESS: 3201 C STREET
ANCHORAGE;, AK 99503
CONTACT PHONE: 563-5500
LEGAL DESCR I P : SUS0; V ISS a 8-I RC -H -TR ESTATES LOT n 5 BLOCK; - i
kCCTION: 34 TOWNSHIP: 12N RANGE: SW
LOT SIZE: 1A (SQ.FT. OR ACRES)
I certify that:
1. I am familiar with the requirements for can --site sewers and wells as arta
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA -codes -and regulAtionso..
and in compliance with the design criteria of this permit.
3„ I will adhere to all MOA and State of Alaska requirements.:for the -set -back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lots
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN ( l) AN ELECTRICAL PERMIT. AND INSPECTION MUST BE OBTAINED; (2) AS --BUILT:
WILL NOT BE. APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND () THE
ELECTRICAL WORK MUST' BE DONE BY A LICENSED ELECTRICIAN.
SIGNED DATE:
APPLICANT: JACK WHITE COMPANY LARRY CLARK
ISSUED BY------------------ DATE: ..
CSC- �� e� ,�_ � •
FLPmeb
72-013 (Rev. 3/78)
MUNICIPALITY OF ANCHORAGE
ra
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING
DIVISION
825 L Street - Anchorage, Alaska 99501
Telephone 264-4720
ON-SITE
SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
❑ NEW
It)
UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
a Q
kr-r-"'CME F `3T s6
i
�__S
p-1 W
LOCATION
NO. OF ODMS
V
DISTANCE TO:
II
Absorption area
b
Dwelling ��
PERMIT �Q
Y
Q
Manufacturer
^
tz'
Material �
No. of compartments
W
`b
�
F
y
Liq. capacity in gallons
IF HOMEMADE:
Inside length
Width C I
.J
Liquid depth } to
1 0
0 a z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
2 F
Manufacturer
Material
Liquid capacity in gallons
II
Foundation
Nearest lot line
PERMIT NO. @@
7 BO 161.
W =
DISTANCE TO:
`
W
Trench i
Distance between lines
LL Z
w
No. of lines
Length of each line
Total length of lines
th y
�
y�
P Z
5
inches
A
_cc
Top of the to finish grade ►1 ..
Material beneath tile
Total effective at�so�ption area
'9 211
C
41 inches
Length
Width
Depth
PERMIT NO.
W
a H
Type of crib
ib diameter
Crib depth
Total effective absorption
area
Wa
WI
Cn
Building foundation
Nearest lot line
DISTANCE TO:
lass
Depth
Driller
Distance to lot line
PERMIT NO.
O�
W
r.
Building foundationSewer
line
Septic tank
Absorption area(s)
DISTANCE TO:
OTHER
PIPE MATERIALS
-6o
"
SOIL TEST RATING
O
iso
�INSTALLER / S
p
Q ow &,4�
d
616
REMARKS
Q 0 O b
a
a
1'O E
y
OVED DATE LEGAL
/1
72-013 (Rev. 3/78)
CHUGIAK, ALASKAKODIAK,
*$I �,
ALASKA
MUNICIPALIT`I4ao-46MRAGE
688-3199
S�
DEPT. ; ',L- .
ENVIRCP ,".: _ CTION
+0110DRILLING CO•
OEC 2 1978
WE SERVE ALL ALASKA
1
POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567
[ „[ I i~ I j
OWNEROF LAND ....... s .:..,....a
..,:.J:..:.................................................
DEPTH OF WELL:.:.................................................................
M .......
ADDRESS ::...... ::.. '. STATIC LEVEL OF WATER FT.
..................... .......... .................
WELL—SITE .r. �. :. ........w.r
: .:........ :........ ...... .... ................... DRAW DOWN FT....:�:.,.....:..tz. ............... .....
DATE— STARTED ., :: W'.........................................................................
GALS. PER HR... .:...........................
....................................
DATE — ENDED .......-:?.................................................................
1�4
KIND OF CASING .......;.Lrt :...� �..»k`.................................
KIND OF FORMATION:
FROM.............
FT. TO ......w..............
FT�,i ,............ FROM ....................... FT. TO ....................... FT. .................................
FROM..
FT. TO 1.; .....,..
FT.FROM ....................... FT. TO ........................
FT.................................
..........
FROM..................
FT.. TO .......21 .........
FT. 4;14:a:" O -l................ FROM ... FT. TO ........................
FT................
FROM ......... F..........
FT. TO ......:C:4,...........
FT.. .......... FROM ....................... FT. TO ........................
FT.................................
.....:: � ........
FROMk
FT. TO ......: s 4.J..........
F'I'. s�� �:..,;a:�,,•�.,i...... .................:.:: FT. TO ........................
FROM
FT ............................... ..
FROM...................
FT. TO ... 1-...............
FT.....:.'b ::'...:......:... `..k.. FROM ....................... FT. TO ........................
FT.................................
FROM......, .w.... .....
FT. TO ... ..:a..........
FT °k.:4 :. x FROM ....................... FT. TO ........................
FT.................................
FROM......................
FT. TO ......................
FT.................................... FROM ....................... FT. TO ........................ FT.................................
FROM......................
FT. TO ......................
FT.................................... FROM ....................... FT. TO ........................ FT.................................
FROM......................
FT. TO ....................
FT.................................... FROM .................. FT. TO ........................ FT.................................
FROM......................
FT. TO ......................
FT.................................... FROM ....................... FT. TO .......................
FT..................................
FROM......................
FT. TO ......................
FT.................................... FROM ................... FT. TO ........................ FT.................................
MISCL. INFORMATION:
DRILLER'S NAME..................................................................................................................
q��H
- DEPHRTMENT OlEHLTH HND ENVIRONMENTHL F `
825 'L STREET, HNCHORHGE, HK995
264-4720 \.^-
........ ........
.
VJ 111
�
THE RED SIZE OF THE SOIL HBSORPTION SYSTEM IS�
�
QjVjlt�,Q VRf)1NPA(-,`I-V 4q
�����=�-�-��=
_ )
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD
THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE
GROUND HND THE BOTTOM OF THE EXCHYHTION (IN FEET)
THERE IS NO SET WIDTH FOR TRENCHES
THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE
HND THE BOTTOM OF THE EXCHYHTION (IN FEET)
�
:J1 H������ �
PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE ��
INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PROPERTY HND THE `
NUMBER OF RESIDENCES THHT THE WELL WILL SERYE`J
�������T A -
BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTION HND HPPROYHL BY THIS
DEPHRTMENT WILL BE SUBJECT TO PROSECUTION
MINIMUM DISTHNCE BETWEEN H WELL HND HNY ON-SITE SEWHGE DISPOSHL SYSTEM IS \
100 FEET
I::: - H PRIYHTE WELL/ OR
150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL
WELL LOGS HRE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHYS
OF THE WELL COMPLETION� `.
OTHER REQUIREMENTS MHY HPPLYSPECIFICHTIONS HND CONSTRUCTION DIHGRHMS HRE '
HYHILHBLE TO INSURE PROPER INSTHLLHTION
I CERTIFY THHT
1� I HM FHIT! ILTHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS HS SET
FORTH BY THE MUNICIPHLITY OF HNCHORHGE
2I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CODES
]' I UNDERSTHND THHT THE ON-SITE SEWER SYSTEM M�Y REQUIRE ENLHRGEMENT IF THE
UDE MORE f:: ] BEDROOMS
SIGN _--_----------
DHTE ���Y]2
ISSUED BY_ ..... .....
XIn SOILS LOG
MUNICIPALITY OF ANCHORAGE El PERCOLATION
•DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
Pouch 6650, Anchorage, Alaska 99602 276-2221
SOILS LOG - PERCOLATION TEST
41
PERFORMED FOR , v 1, is DATE PERFORMED
: -
LEGAL DESCRIPTION. •.,jSLOPE SITE PLAN
FD—E—P—THI
4
(FEET)
L
2•
3.
4-
5 -
6-
7
8
9
10
11
12
13
14
15
16
17
18
19
WAS GROUND WATER S
ENCOUNTERED? L
0
P
E
IF YES, AT WHAT
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN
FT AND
— FT
COMMENTS
20
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN
FT AND
— FT
COMMENTS
e. 7
B44C(
CERTIFIED
BY
4$(C
72-008 (7/76)
tSTirv6 YM
IST e IF
E� X577 S `CSS
Q�r;pos
E {-1 s -ft Au 6 5TOE L
�t Sa CYuNef--n TOW' -
s (F 8 kr
E9
PERFORMED FOR/.!jZ
LEGAL DESCRIPTION:
DEPTH
(FEET)
1
2-
3-
4-
5 345
6
7-
8-
9.
-8•9.
10•
11
12
13
14
15
16
17
18
19
— 1... "' +t �rSl SOILS LOG
C tc
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIO O PERCOLATION
TEST
Pouch 6.660, Anchorage, Alaska 99602 276-2221
SOILS LOG PERCOLATION TEST
LU�'1
s4 -.o -So
SLOPE
DATE PERFORMED:
SITE PLAN
WAS GROUND WATER,~ _ L
ENCOUNTERED?
C�G1I ! IF YES, AT WHAT / E
DEPTH? V
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
T
N
20 I I PERCOLATION RATE (minutes/inch)
u�TEST RUN BETWEEN �—� FT AND FT
� c� G'GL� GSL -'j—
z'
>� e-L"r .'61 / C�'L'?✓ I -,y � %f'. / �j ��7
/f
COMMENTS All
PERFORMED BY:
/Y%pSF,J(� CERTIFIED BY:
i�
40
({',',',`v) ilk-- c' �. , �, _ ��1 _ i� r-' �! � is __ 1-"1..1 r 9 l.� (i`� l/ � Ctil.. � \N" �' ✓.
'OP Of FOUNDATION WALL ELEVATION= 491 .0
Lr VATIDN•S RASED ON. & GS 1 972 DATow
'REPAIRED FOR
Don Carroll
PLOT PLAN
DES DATE v.. 1 .�.:iD �t1 .
DAG 9/7/18 hg Tlgo
FMK JHH GR,^
° X'D0.139 ''°° 18105 .3037
00ts.
I hereby certify that an actura-;
survey of the Droperty shop
hereon was made on 7'7& ari3
the corners exis•t-'iVsry3:r,,,
IT SMALL HE TME RESPONSIRIL I T O' T"E b✓,LDER OH �•� y, • `•� E
tin
OWNER TO VERIFY TMAT 8u,:C-Ni.-OCATIOh SHOWN '� a
f
MEETS ALL SUDDIVI"IOM COvfkANTS AND LOCAL ZOh- f
•� Fn ,�.•�7
ING CODES AND ORDINANCES.+� •w�y�� (`% �•��
LOT 5 BLOCK 1 ��"'' N°-3
BIRCH TREE ESTATES r�',��' �•r
TOW AVENUE -•
_ h
�--
`�L
o
' �o
tole ��NsT�UN)r
•r��
-T °PR. C4 PA Pi- JT
? s
1'1�o%-3.00
589051 ' 9„ W
M
ss P.
i
Eley. 4$3f
. I 5t/°7ri�• �,�V�'
E/ey 49/�
SCALE
•
'
/
lit •�Ji's {', t I
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PLOT PLAN
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I hereby certify that an actura-;
survey of the Droperty shop
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the corners exis•t-'iVsry3:r,,,
IT SMALL HE TME RESPONSIRIL I T O' T"E b✓,LDER OH �•� y, • `•� E
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f
MEETS ALL SUDDIVI"IOM COvfkANTS AND LOCAL ZOh- f
•� Fn ,�.•�7
ING CODES AND ORDINANCES.+� •w�y�� (`% �•��
LOT 5 BLOCK 1 ��"'' N°-3
BIRCH TREE ESTATES r�',��' �•r
s -HD GR" 'TER ANCHORAGE AREA BOROI �4
OL..IRTMENT OF ENVIRONMENTAL QUALI; _
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING .c�OX �3v``r PH0NE`�� -9 90
NAME—���f/� `/' ���C� --- ADDRESS
LOCATION__ �///ED.!/ /�Oi9D _ _ LEGAL DESCRIPTION
CCDTIr TANIV.
/ NUMBER OF
DISTANCE FROM WELL. —MATERIA LSTEEL COMPARTMENTS
.S'TEEG Fiy�3�C/G�QTo,�S a4 * /7q0 63 LIQUID
LIQUID CAPACITY /"0 --GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH /3 LENGTH DEPTH
LINING MATERIAL / '��� gX i?� • DISTANCE FROM WELL 174BUILDING FOUNDATION
NEAREST LOT LINE / t TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 4o` 56 SQ. FT.
TIL FIELD:
DISTANCE FROM WELL_
NUMBER OF LINES_
ABSORPTION AREA_
TOTAL LENGTH
-�UNDATION NEAREST LOT LINE OF LINES
STANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
TRENCH WIDTH
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOV-I!-TP,E
&I e,9SIN6 / DISTANCE FROM / WATER
WELL: TYPE/oXlk/i r—' DEPTH �6S BUILDING FOUNDATION. 35 _SAMPLE NEAREST
/ NEAREST SEPTIC / SEEPAGE / OTHER
LOT LINE SEWER LINE TANK �e0 f SYSTEM /�D �` CESSPOOL �0�!/E SOURCES
DISTANCES:
G'f9ST /.4DA
�J/?-AI�EG f3flC.E
.By
m ✓, .tMPA/CE
�i2r/GST
DIAGRAM OF SYSTEM
DATE
/"- /If' �� APPROVED / �/
G.A.A.B.
GREA. t:R ANCHORAGE AREA BOR.-JGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3500 TUDCFR ROAD F'CUCH C"550
ANICHORAGE. ALASKA 99502
T[I.EPHONE 279.8566
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
Syy 7-/70
NAME OF APPLICANT ' "/�/l /�N "-«--A1 O- Y�=-j --- MAILING ADDRESS �_ 'f _ �� _�1 �4 PHONE
INSTALLATION LOCATION - _-
LEGAL DESCRIPTION,//PCi`}/PEE
INSTALLATION OF: SEPTIC TANK LJ SEEPAGE PIT_—,
IT__ , DRAIN FIELD . OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
/ TO BE INSTALLED BY �I
SOIL TEST RESULTS NOTEt THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED / '
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
/ ©� � TYPEStPP� OY CQ CYPtPSEEPAGE AREA SIZE /'132TYPE/' } R/a -
MINIMUM DISTANCES, REQUIREMENTS
5 ft.
FOUNDATION TO SEPTIC TANK '
FOUNDATION TO SEEPAGE PIT 20 ft. DRAIN FIELD 10 ft.
SEPTIC TANK TO SEEPAGE PIT WALL 15 ft.
SEPTIC TANK _-5—J11— SEEPAGE PIT 20 ft- . DRAIN FIELD ADftp
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK /��rr1V6 E;'/ SEEPAGE PI "T' —,L%%(�J
"� '
DRAIN FIELD Lyo ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK 10 ft, SEEPAGE PIT 10 ft -
DRAIN FIELD 1.0 ft...,_
SEPTIC TANK, 25 ft., SEEPAGE PIT 100 ft• , DRAIN FIELD 50 ft,
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
gGuGi.
DIAGRAM OF SYSTEM
4" CAST IRON SI PITON �-
SEPTIC PIP( TTH AIRTIGHT CRIB
IMM ,/ CAPS
•,Sr---.._..----..5.%///IRI1 MT,ett'�lty„
CAST- lPl'•'
Level —4
CAST IRON
INTO
UNDISTURBED SOIL
15' i
}MINMLI"r MINIMUM
C I required whenever line crosses
under driveway,
t!II;1"OPf 4!f. Ll.
UI?'EACfS�
111 �t1V1111IA1.
IN;0'
10 PIT- 100'
G0 Si.4:I:R LINE- 10'
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
SEP!-I'UOLIC
FITTED WITH AIRTIGHT REMOVABLE CAPS.
10 TANK- 80'•
'
TO PIT- 120'
h0 SI'CER LINji- 40'
BACKFILL
40'-h1 01!LY
GRAVEL
GnIPnn ;lEr,
SEWER
L Ir.E
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
IAML_IC
T/U1K- 200'
21'0
PI7 - 200'
'
100'•2( 0' OJ:Lv
CA`T IRON SEWER
10n .n�i SOUPCE OF
'I:Ar^. NAiION
HEALTH AUTHORITY
OR
LICENSED DESIGNER
yRAVEL BAGG0111. .
ARUNO CRIB. '
(CRIB 4.' MINIMUM ABOVE NATER
TABLE)
4 INCH SEVER LINE
CONSIOIR AREA WELLS.
SEEPAGE Pil EXCAVATION BASED ON
SOIL TEST.
,*ILLS•
Grade: F.' per 100'
or 1/4" pr foot
except 10' precrAing
tank d tha. should 1
not exceed 25. - i
6' per 100 on flat
CAST iPOtl. terrains.
1 SEPTIC
I'IPC 5' �: TAO; /
I N -_.__I TD t!N- ---- 4 RICH
OISTUPOCO i CAST IRON SIPHON PIPE
SOIL ;
SEEPAGE PIT
til
IJ CRIB
GRAVEL OACKFILL
20, MINIMUM
_...__..—_.�__. NEAREST LO
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH OPPINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ��� -_ A
DATE r ` APPLICANT'S SIGNATU
GREA t ER ANCHORAGE AREA BORQUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
NAME OF APPLICANT ._..X.Ll1J�F_t,.l 6J 4 MAILING ADDRESS •`-'d!' 2 O -Al �'• 04 PHONE
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK c_-- /� SEEPAGE PIT �`— DRAIN FIELD OTHER ,
TYPE AND SIZE OF FACILITY TO BE SERVED "S Z3 �ldNa FIQo�d A
FINANCED THROUGH TO BE INSTALLED BY Y.0
SOIL TEST RESULTS / ® JLsdNOTE- THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED��`t-
FINAL INSPECTION.- 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE .&wo TYPE SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT .2o DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK % 0 I SEEPAGE PIT /0e /
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK /.{� I SEEPAGE PIT �a f
DRAIN FIELD
� I d
SEPTIC TANK, —, SEEPAGE PIT /`�� DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
1
HEALTH AUTHORIT
OR
LICENSED DESIG ER
DIAGRAM OF SYSTEM
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE `-"� M 2 2Z APPLICANT'S SIGNATURE
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 017-141-46
Certificate of On -Site Systems Approval
Expiration Date:
Legal description BIRCH TREEESTATES BLK 1 LT 5
Site address 5200 RIVERTON AVE Anchorage AK
Current property owner(s) SULLIVAN
8/21 /2025
X The On -site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 9/26/2024
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section �v Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 017-141-46
Complete legal description BIRCH TREE ESTATES; BLOCK 1, LOT 5
Location (site address) 5200 RIVERTON AVE., ANCHORAGE, AK _
Current -property Dwner(sal MATT SULLIVAN
f
2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone 907-717-3267
3. TYPE OF WATER SUPPLY: X Private Well F] Private Well serving 2 dwelling units
F] Private Well serving 3+ dwelling units M Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: OF Private Septic F Private Septic serving 2 dwelling units
F-1 Holding Tank Fj Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel A-1 Plastic ❑ Concrete F-I Fiberglass
Age 6 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: F-01 AWWTS El Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: F1
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On -site staff
to verify the accuracy of the information provided.
COSA Fee $
Date of Payment
COSA #
Waiver Fee $
Date of Payment
Waiver #
COSA Applicalionjune 2022
COSA Checklist
Legal Description: BIRCH TREE ESTATES; BLOCK 1, LOT 5
Parcel ID: 017-141-46
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1
A. WELL DATA
H Well log is filed with Onsite (or attached)
Date drilled 11/1/1978 Total depth 153 ft
Cased to UNK ft
AN Sanitary seal is functioning correctly
OR Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 8/21 /2024
Static water level at beginning of test 88.4 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping ;SEE MAINTENANCE LOG
R Required maintenance completed, if AWWTS
Comments: *SEE MAINTENANCE LOG
Well production at time of test 1.8+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes ® No
INN Coliform bacteria is Negative
Nitrate mg/L N Nitrate less than MRL (ND)
Arsenic ug/L 140 Arsenic less than MRL (ND)
Collected by GEG, LTD.
Date 8/21/2024
C. LIFT STATION
M Required maintenance completed
Age of lift station 6 years
Lift station material PLASTIC
Comments: *SEE MAINTENANCE LOG
D. ABSORPTION FIELD DATA NOTE: THIS IS A SUBSURFACE DRAIN FOR A BIOBARRIER AWWTS
Which system tested (date installed) 8/3/2018 Ade uac test date *8/23-24/2024
MN ALL standpipes present per record drawing
Total measured depth from grade **7•4 ft (max)
Measured depth to pipe invert from grade **6•4 ft (min)
❑ NIA — pressurized field.
❑ Per record drawings, field is insulated.
0 Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N/A
If yes, enter date
q y
Results Q Pass
Fluid depth prior to test ** in
Water added 462 gal
**
New fluid depth in
Elapsed time ** min
**
Final fluid depth in
Absorption rate "450+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) **12 in
Effective depth used **3•5 in
Effective depth remaining **8.5 in
Comments/Deficiencies: **SEE ATTACHED REPORT EXPLAINING SEPTIC AEQUACY TEST.
There is no record profile drawing in the MOA records showing the drainfield elevations.
COSA Checklist June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
Yes if No *50 + ft E Yes if No ft
Neighboring Tank > 100' 0 Yes if No **50 + ft Private Sewer/Septic Line > 25' Q Yes if No ft
Absorption Field on Lot > 100' ❑ Yes if No *50 + ft Holding Tank > 100' M Yes if No ft
Neighboring Absorption Fields > 100' **50'+ Animal Containment > 50' M Yes if No ft
Qi Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑N Yes if No ft W Yes if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑■ Yes if No ft Surface Water > 100' ❑ Yes if No ft
Tank to Property Line > 5'
Field to Property Line > 10'
Water Main > 10'
***3
Yes if No ft
❑Q Yes if No ft
❑■ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100'
Community Wells > 200'
FEI Yes if No **50+ ft
FEI Yes if No ft
Water Service Line > 10' 0 Yes if No ft If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*FOR AWWTS ONSITE. **FOR AWWTS ON ADJACENT PROPERTIES.
***1-FOOT LOT LINE WAIVER GRANTED (OSV181020).
**** See record drawings for location of deck.
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on -site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Gamess Engineering Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Garness Date q 11 t ! 2 `¢
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in
accordance with the guidelines and regulations established by the Municipality of Anchorage and industry o�0�00
practices. The reported results describe the condition of the system/s on the date/s of the evaluation. o�^ Q�
Separation distances were measured to readily identifiable features. Hidden defects or encroachments may o ..
exist that were not identified during the evaluation. The operational life of all wells and septic systems depend o S
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing * 49
the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not .......... ..:...
.. ...
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding w�
the future performance of the well or septic system. GEG makes no representation whether an alternative well I
or septic system can be installed on the property in the event either of the current systems fail to perform Q .eA.���� �Gorr} ss
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG QQ P CE;953 .
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. �� P e
0
LICENSE ��(y P� o f e s sian�o
COSA Checklist June 2022 a,Eccaea
Q, - Z
GARNESS ENGINEERING GROUP, Ltd
ENGINEERING SALES CONSULTING
September 10, 2024
i
i
Municipality of Anchorage
Development Service Department �'d,s
��►`��. O F, A
......
lI
.. �...1r7.....
On -Site Water & Wastewater Program w �.--� '1j
4700 Elmore Road
Anchorage, AK 99507 n
Ref: Birch Tree Estates; Block 1, Lot 5 - Explanation of Septic Adequacy Test
To whom it may concern:
erness..... ��,
C 7 3
.�{� a?.:
ftFESSI�N� �s
The existing 3-bedroom house is served by a private well and septic system. The septic system
was installed in 2018 and consists of a "BioBarrier" AWWTS and a 5-wide drainfield that is 11
feet long, with an effective depth of 1.0 feet. The total absorption area is only 62.5 ft2. The
following is an explanation of the septic system adequacy test.
On 8/21/2024, the drainfield monitoring tube (MT) was found to be dry. Water was introduced
directly into the drainfield (through a cleanout) at a rate of 2 gpm. After introducing only 144
gallons of water, the drainfield was surcharged with 15" of liquid in the MT, so the introduction
of water was discontinued. During the recovery period the owners were using water inside the
residence and the liquid level in the drainfield rose to a depth of 30 inches. At no point did we
observe the water from the drainfield flowing back towards the AWWTS. On 8/22/2024, we
returned to the property and found the MT to be dry.
After discussions with ARM Septic Services (the service provider for this BioBarrier system) and
Jay Crewdson, PE (the design engineer for this system), we decided to retest the drainfield by
introducing the water directly into the BioBarrier AWWTS and allowing it to discharge (on a time -
dose basis) to the drainfield using the BioBarrier discharge pump. It is our understanding that this
pump runs at a rate of —0.4 to 0.5 gpm.
On 8/23/2024, we returned to the property and found the drainfield MT to be dry. We coordinated
with the homeowner for no water to be used in the house during our retest. At 12:33 pm we began
the introduction of water into the BioBarrier tank and at 12:43 pm the BioBarrier discharge pump
activated and began to transfer water to the drainfield. A total of 390 gallons was introduced into
the BioBarrier tank causing it to be filled to the inlet invert. At 2:05 pm, we stopped the
introduction of water into the BioBarrier tank and measured 6.5 inches of liquid in the drainfield
MT. The BioBarrier system continued to discharge water to the drainfield overnight. On
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
Page 2 of 2
8/24/2024, we returned to the property and found that the BioBarrier discharge pump was not
running and there was 1 inch of liquid in the drainfield MT. Starting at 8:10 AM, an additional 72
gallons was introduced into the BioBarrier tank, again causing the BioBarrier discharge pump to
activate and transfer water to the drainfield. The BioBarrier discharge pump shut-off at 10:21 AM
after transferring the 72 additional gallons to drainfield. At that time there was 8.75 inches of
liquid in the drainfield. A total of 462 gallons of water was introduced into the drainfield over a
period of 1,308 minutes. At 12:31 pm on 8/24/24 (130 minutes into the recovery period), the liquid
depth in the MT was found to be 3.5" (a drop of 5.25").
The recovery rate was calculated as follows:
72 gallons with 7.75-inch rise = 9.3 gallons/inch.
9.3 gallons/inch X 5.25-inch drop = 48.8 gallons absorbed in 130 minutes = 0.38 gpm
0.38 gallons/minute X 1440 minute/day = 540+ gpd.
Based upon this data, it appears that drainfield will absorb 450+ gpd. o;"
13 G7�-- q tz 5/ z r S (J�
It is arguable, based upon the MO AWWTS regulations, that the existing drainfield is undersized.
Given the soil percolation rate of minutes per inch, the number of bedrooms (3), and the MOA
established soil application rate for CAT III effluent 6(4 gpd/ft2), the drainfield absorption area
should be a minimum ofqyie�MQA
ft2. The existing drainfield has an absorption area of only 62.5 ft2;
however, it was approved in 2018.
If you have any questions, please conta4 me 337-6179. Thank you for your assistance.
�-i erely,
Jeffrey A6 6G�,arnes.E., M.S.
Presi nt
Cv F� 2
""'
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineering.com
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this 23rd Day of September of 20 24 , by and between
Clayton Beethe , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as BioBarrier
located at (legal description)
Birch Tree Estates l.5 B1 5200 Riverton Avenue, Anchorage, AK 99516
2. Maintenance. Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of
Owner acknowledges that the Municipality may request records of maintenance and
(1') repairs from the manufacturer's representative or maintenance provider.
�-� Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction. Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
By: (signature) Date:
Ur
Clay on Beethe (print name)
STATE OF ALASKA
) ss.
THIRD JUDICIAL DISTRICT
9/23/2024
The foregoing instrument was acknowledged before me this 2Z�ay of ��j `rn Imo-
20,-Zq, by U a Li -Io n
tit
15RO
NOTARY PUBLIC FOYR ALASKA
My Commission expires: -T-1-209 7 W
MUNICIPALITY:
UBy: _ ---- (signature)
T\9 L —/— 5 i-�� (print name)
)"ATF-
�p4 ~
Date:
Title:
(rev. 05/18/2018) Page 3 of 3
sErrER WATER.
BETTER WORLD,
18368 Amonsor, Rd DENALIak,F,N VIR0 WFNTAI, , • Chugrak, AK 99567 SI-�'P1. Y
FIELD • Phone 907-280.9493 .
INSPECTION F matt cellc.l@outlook eom
BioBarrierjvMBR Systems `� SERVICE REPORT
INSTALLATION—
ln`tellatlonAddres.,
01vne2 Nance h - -v ko r�
i
Mail Addres
� ,State
AUTHORIZED S RVICE PR E
_ Tylyl,{ c -- --�
Street �+C)Cillltg $
_ I�43� L
Mall Address `
Phone
le mail
1 _ -Phone
INSTALLATION INFORMATION
Model No 131011er Brand and T
Serial No. Date of Installation Date o#'last pump out
- Size �F ^� �� T _�in —
�M �0
17- A 7 �zof
'COMPONENT
FUNCTION
PROCEDURE
RESULT
BLOWER
OPERATION
Open btot%er housing check to
�confimt that blower is running (be
re bfoner is ON and sho«s ON in
c BB panel.
[Reinoiewing
nut from intake
INTAKE FILTER
AA
assembly on bloner, remove all
debris from filter clement Put
Place control panel into MANUAL
CONTROL PANEL
AUDIO & VISUAL
FUNCTION
MODE then turn the blo%ker OFF.
See "Manual Mode" directions in
[�
sere ice manual for proper execution
of this task
Remo%c col er from matiliole oA-cr
REACTION
BEING AERATED
CHAMBER
BioBarrier sx stem and check to be
sure Vigorous boiling is oeurring
(unless panel indicates the system is
in LTRP mode)
Check Solids Remo al procedure in
SOLIDS
t t
REM0�1 AL
the Sere sce Matlual
--t'OIVIPONENT -..--.
FUNCTION
PROCEDURE
INTAKES
AND
Remove any
INTAKES nN
BLOWER
obst►uctious from the
intake louvres on the
5A NITEE® -
HOUSG
. IN
---
blower housing and
EFFLUENT
CLEAN THE _._.
SCREEN
_ .-------
Clean b� using the built in
SCREEN
--------------
swab feature or other
---
WATER
OUALIT�'
I
`` '- ----- �--_ method _
ViEVi'---------¢-_ :.
EFFLUENT Visualk, obsen e final
effluent of Bio$arrier
-----------
s� stem Effluent
be clear.
CHECK ODOR
__should
5tnel! odor at BioBarrier
vent. it should be a damp.
carthv odor
MEMBRANE
CARTRIDGE
CHF,MICAL
CLEANING
SALE
"COLLECTION OF
FFFI,I JF.NT
.1AMPi,F"
_
section of the ien�ice
Manual
LIt�UiD--`
-Take temperature reading at
TENU'ERA,f URE
least 6 inches beloA% the top
Of the liquid
CLEAN IN PLACE
INTENSE
OXIDATIVE
CLEANING &
CITRIC
Check FILT tiit�e on�
control panel. If it
cNeecded 16 00 hrs
OR the vacuum
reading on the
filtration pump is -7 psi (-
1 ct" t-tul nr
LESS. AND the
SN'stem floats are
oneratine caTcctly.
then perform the CIP
procedure according
to the instructions in
the Sen'ice Manual.
Perform this cleaning- -
procedure after four
consecutive CIP
Procedures have been
performcd. Sec the
Scn•ice Manual for II
proper procedture.
RESULT —_----
cl-yvvffiElc-- OF
TREATME
FILT Reading:
G '-1,r
REST Reading:
CT
UUMPONENT FUNCTION ---_
_—
DRAINFIELD
_ _
LIQUID LEVEL -- --- - - _ --_-_
OCEDURE RESULT
-�-__ . ___
Y- -
k and record
lei eI to ensure r
t dispersion of
Tensure
d effluent-
SAND FILTER
VIEW TOP OF FILTERop
5�1r
of sand to
sand is cleanpears
to be
absorbing
ent without
SETTLING TANK - _ng
SLUDGE JUDGEa
or backing
core sample of
tapting/
tthng chamber ,
cn�iin_ if
ig ,s necessary.
TREATMENT TANK SLUDGE JUDGE_
__ _
core sample o£
atment
chamber to determine
if pumping is
BLOWER
— --- -
PROPER OPERATION
necessar\
- --
Visually obsen e
1
E
igorous boiling in /'
, manholes where `-Q61,e
bloiiers are installed.
LID TIGHT
Check that the serev s
are snug/ tight before
I
leaving. (�•'� - e
REMOTE
PROPER OPERATION
Lift high 11-ater float
MONITORING
and ensure RMS ,s
i SYSTEM
operating properly
and Sending out
MANHOLE RISER
INSULATION PLUG MSTAILED ��
'ilert_� -'- --`- - -
Check to make sure
Note. Some systemsuse all insulated lid and do
insulation plug �► as �.
�-
not have in insulation plug,
reinstalled con•ectl.-
Check to ensure lids
- ----
DOOR SEAL OPERATING PROPERLY
are secured ,� n
Check ihat the door
CONTROL PANEL
1"'Gathcr seal appears
to be n orking and the
- .— -
BLOWER AMGE DRAW -_- --�-
PERA
scree s are snug/
-
of
Nota
e amperage drag•.
CONTROL PANEL IN AUTO w -
^Ensure operation
mode 2'GSCt I4 auto,
SYSTEM - —
OVERVIEW
OTHER SYSTEM
COMPONENTS
CHECK FOR
UNUSUAL
ACTIVITY
ML,55
A155�-
OWNER SIGNATURE
Send completed form to Denali Environtnen
Make sure there iS no
unusual traffic Over S� stcm
(ic cars, motorhomes, etc.)
CLAN SIGNATURE
Ok
26%
SERVICE DATE
i�h+ cf $`
Municipality of Anchorage ='a
On -Site Water and Wastewater Program
F
(907) 343-7904 s.'E,. c
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel l.D. 017-141-46
1. GENERAL INFORMATION
Expiration Date:
Complete legal description BIRCH TREE ESTATES BLOCK 1 LOT 5
Location (site address) 5200 RIVERTON RAVE, ANCHORAGE AK 99516
Current Property owner(s) WILLIAM & ELEANOR ANDERSON Day phone
Mailing address
Real Estate Agent
523 RIVER ROAD STANDISM ME 04084
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
WaiverNarianoe request for:
Received by:
COSA to be released to the engineer, unless
COSA Fee $ 5a (a w
Date of Payment
Receipt Number OJ�J�'JVO
COSA# a5-1)41tl0a
3
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank ❑
Cottiiir7
unity u
Public Sewer ❑
Date:
i
by the engineer.
Waiver Fee $ _
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING INC Phone 868-3791
Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 3/24/14
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the
condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to
subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that
may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic
systems are subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerfa guarantee that no unseen i
encroachments, deficiencies or discrepancies exist. o-`141�� lilt
*til -P 1B
6. DSD SIGNATURE !
'A :
System #1 Approved for � bedrooms. + KEL TM. PG J01
System #2 Approved for bedrooms. ;13 I>
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
6c v
L p
BY:�� C� : �. Cr"�-- Original Certificate Date:
The o{ sorage Development Services Division (DSO) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The
Municipality of Anchorage Is not responsible for errors or omissions In the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
If more than 1 septic system is on the tot:
COSA Checklist # _of _
Structure served by this system _
Certificate of On -Site Systems Approval Checklist
Legal Description: QIRCH TREE ESTATES BLOCK 1 LOT 5 Parcel ID: 017-141-46
A. WELL DATA
Well type PRVT If A. B, or C provide PWSID # _ Well Log (Y/N) Y
Date completed 1111978 Sanitary seal (YIN) Y Wires properly protected (YIN) Y
Tota! depth 153 ft. Cased to 1i_ft. Casing height (above ground) 24+ in.
FROM WELL LOG AT INSPECTION
Date of test 111111978 311312014
Static water level 70 fL 93 ft.
Well production 5 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEl3 colondes/100 mL Nitrate_ go mg/L
Arsenic: -.._ ND ug/L Date of sample: 3113/2014
B. SEPTICI/HOLDING TANK DATA
Tank Type/Material _J%ffIC I STEEL
Tank size 1250 gat. Number of Compartments 2
Foundation cleanout (YIN) Y Depression over tank (Y/N) N
Date of pumping "4 Pumper A+
Collected by: ARCTERRA
Date installed _8127N996
Cleanouts (Y/N) Y
High water alarm (Y/N) N
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./fta or ft tbdrm) 0.7 System type BED
Length 65 ft. Width 10 ft. Gravel below pipe 0.5 ft.
Total depth 2.0 ft. MOMred 3113114) Eff. absorption area QQQ.ft2 Monitoring tube Y Depression over field N
Date of adequacy test ;if1312014 Results (Pass/Fail) PAS For 3 bedrooms
Fluid depth in absorption field before test Q in. Water added 600 gal. New depth 5 in.
Elapsed Time: 100 min. Final fluid depth U in. Absorption rate >= 450+ g.pAd
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
D. LIFT STATION
Date Installed 6/1711M Size in gallons 340 Manhole/Access (YIN) Y
"Pump on" level at 28 in. "Pump off' levet at 18 in. High water alarm level at 34 in.
Datum TANK BOTTOM) Cycles tested 2 Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tankilift station on lot 1001+
Absorption field on lot 100'+
Public sewer main 75'+
Sewer /septic service line 254
Animal containment areas 50'+
SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property line �+
On adjacent lots 100'+
On adjacent lots 1004
Public sewer manhole/cleanout 100'+
Holding tank 100'+
Manure/animal excrete storage areas 1004
Absorption field 5'+
Water main 104 Water service fine 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line IIY+ Building foundation 104 Water main 104
Water Service line IV+ Surface water 100'+ Driveway, parkingivehide storage 1104
Curtain drain 50'+ ( KWffl) Wells on adjacent lots001 '+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that t have determined through field inspections and
review of Municipal records that the above systems are in conformance
with MOA COSA guidelines to effect on this date. + OF ALS
Engineer's Printed Name KENNETH Mt. OUFFUS
9
Data 3=4f * 49 T13 F t
conA brovn, sheet_10-10-12.doc
9� KEYh'ETN ly6 D
3 4NP4 �
RIVERTON AVENUE
alwnwc zleAot M
S890 51' 09"W 143.00'
V
C !+
WELL
�2
.s0 EXISTI A.
HOUSE
4
— — — — — — 10' —UTIL — —ES—MT — — — — — — — —
143.00' N89° 43'44"E
UNDER NO CIRCUMSTANCES SHOULD AN AS—BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES.
THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCAUNG. REPRODUCTION MAY CAUSE ERRORS IN SCALE
LOT s WY SURVEY TYPE SYMBOLS
❑ FWMA110N AS—RXT SET REBAR DRAINAGE = ASPHALT
❑ MAL STRUCTURE AS-auLT O FOUND REBAR e-4-$ WOOD FENCE ..:: CONCRETE
mPLOT PLAR .... BUI��T .. K nSu�Rti�Y�._or .P — __ _' COO� ASSUMED ELEV. I( It X METAL FENCE ® WOOD DECK
IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE
THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.
SURVEY CERTIFICATION ...*`19 YAl ,,
PLOT PLAN ��'�� OF I 'A ,,
AS-BINLT
STRUCTURE AS-BIRLT
s.. 0—�9Yh
ROBERT OHNSH R. ...'t....
Y • � L
4121—S .' eA A
is ••••'•....•••• �i �1
e n 00",
ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
SHOWN. FENCES. WELLS. SEPTIC CLEANOUTS. SIDEWALKS, DRIVEWAYS,
ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW
MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED.
Robert E. Johns, Jr. & Assoc.
Professional Land Surveyors
1700 86.k DN".
ANCHORAGE. ALASKA 84504
40' Rea Lot S.F. Rea. Plat Flle No.
rte Surveyed: 03/13/14 Drown bY• REJ Checked bj`MK
rte Draw 03/13/14 Grkl: 3037 W'D' 14-78
:gal De Kpllon:
Lot 5 Block 1
BIRCH TREE ESTATES
MUNICIPALITY OFANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERV IC
Division of Environ ES AtUl
On -Site Services Sect on vices
P•0. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel l.D.# Q/ 7— /•— y6
• GENERAL INFORMATION HAA #�
Complete legal description
Blaek 7. „_-
Location (site address or directions) 5200 Riverton Aven
ue
Anchora e/ AK
Property, owner La'
}`'Mailing.address 5200wRiverton Ave. Day Phone 345-6692
Lendin Anchora e AK 99516
9 agency �.
Mailing address Day phone
Agent Ra Dahl `J auric pro
rti
Address Day phone
Unless otherwise requested, HAA will be held for Pickup.
2- NUMBER OF BEDROOMS: 3 p
3. TYPE OF WATER SUPPLY:
Individual well
Community well
' Public water
NOTE:
If community well system, provide written confirmation fro
ing to the legality and status of system.. m State ADE C attest-
4- TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community
attesting to the lega/wy and tam' provide written confirmation from S
tus of system. tate ADEC
72-025 (Rev. 1/91) Front MOA 021
in
5. STATEMENT OF INSPECTION BY ENGINEER I verify that my
'seal affixed hereto and as of the validate shows that the on site water supply
n date shown below
As certified by MY Approval application
investigation of this Health Authority PP information obtained from
and/or wastewater disposal system is safe, functional and adequate for the number of bedroom
investigation and inspection, the on-site water
type of structure indicated herein. I further verify that based on the c
and yp
the Municipality of Anchorage files and from in compliance with all Municipal and State
I and/or wastewater disposal system is in comp inspection.
supply GIq-�-q7g
ordinances, and regulations in effect on the date of this insp
Phone
Name of Firm S & S ENGINEERING
17034 Eagle River Loop Road No. 204 -21/
Address Date
6 a
Engineer's signature
I %%i
g. DHHS SIGNATURE bedrooms.
Approved for
Disapproved.
Conditional approval for ----
Additional Comments
By:
C -WFV ROBERT
CE - 8801
l�ci� �� • r '�,Le
bedrooms, with the following stipulations:
Date 2 B
independent
ment of Health and Human Services (Dh 5 above by aHS) issues Health ndepe Duty
upon the representations given in paragraph The Municipality of Anchorage Depa to purchasers of homes
Approval Certificates based only P uirements. Employees of DHHS do not
I engineer registered in the State of Alaskfeder° andstatedoes as a courtesy Anchorage is not
profess+ona 9
and their lending institutions in order to satisfy certain
conduct inspections or an
data before a certiI engin�sswo issued. Municipality Of
responsible for errors or omissions in the professiona engineer's
MOA N21
T2_M (Rev. 1/91) SWIk
RECEIVED
Municipalityof Anchorage JUN
DEPARTMENT OF HEALTH &HUMAN SERVICEW10PAU Y Of ANCHO
Environmental Services Division fNviRONME'°SviCS.D_
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
Health Authority Approval Checklist
Legal Description: LD T S 8LK t Q lR(.14 1'RtC Parcel I.D.: © f '7 -1 'It - 46
A. WELL DATA
Well type PiR "V 4 7- t If A, B, or C, attach ADEC letter. ADEC water system number
Log present 0/N) y S Date completed >> 7T
Total depth 1 3 Cased to I S-3 , Casing height (above ground)
Sanitary seal &N} Wires properly protected 6)N) V'E 1
FROM WELL LOG AT INSPECTION
Date of test tr rl r r' 75 (� !'i 7 I R 5.
Static water level Z4 > 01
Well production 9-P.M. 3` '5 g.p.m.
WATER SAMPLE RESULTS:
Coliform o Nitrate Other bacteria 0
Date of sample: ' ► - t q $ Collected by: S & S ENGINEERING
17034 Eagle River Loop Road No.
2N17—
B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska M77
Date installed b? /36 Tank size I Sp Number of Compartments Cleanouts O/N) Y& J
Foundation cleanout _Y f-3 Depression (Y10 110 High water alarm (Y/(91j
Date ofriJ;,tumpin g. Pumper
C. ABSOAOT"ION FIELD DATA ....
Date ir$telled' `' -7 Soil rating(g.p.d./ft2 orft2/bdrm) System type 7.el. e- t-,H
Length ' #- 66 Width C_ Gravel thickness below pipe i Total depth I 'A
Effective absorption area . Monitoring Tube present/N) Y J Depression over field (Y& ^'
Date of adequacy test N 1,4 Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test (in.); Immediately after ater added (in.):
Fluid depth (ins} Minutes late Absorption rate' = g.p.d.
Peroxide treatm s 12 months) (Y/N) If yes, give date
72-026 (Rev. 3/96)"
D. LIFT STATION
Date installed 6 /''7 % °I f Size in gallons
Manhole/Access (9/N) y C -S "Pump on" level at* a 8'
High water alarm level at* 3 y *Datum 7 ^'" 3 rr 0
Cycles tested JL
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot 1 0 0
Absorption field on lot _
Public sewer main
On adjacent lots
On adjacent lots
VOO
"Pump off" level at* /
/00 �
"00
Public sewer manhole/cleanout N 14
Sewer /septic service line S' '� Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
io0� a--
Foundation / o r "� Property line Absorption field '� /-o`
r ,
Water main/service line 10 "- Surface water/drainage /O 0 4- Wells on adjacent lots /00
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
4-011
Property line 3 Zewa„ ksT��uilding foundation 6 a r Water main/service line %a
r �
Surface water n 4- Driveway, parking/vehicle storage area 5 -
Curtain
Curtain drain ° W ^v Wells on adjacent lots /00
r'v
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal
in conformance with MOAA idelines in effect on this date.
Signatures
Engineer's Name �� ��� C- Co .J*,J
Date
r
ST"74%.41S-
rtt�;;
,ms are
A� rtoeeRT C01NAN k
J,• ..•••
HAA Fee $ ,5 % Waiver Fee $
Date of Payment Z-20 Date of Payment to -�3—
Receipt Number Z7} Receipt Number L slG) Q.C51 -bi--
72-026 (Rev. 3/96)*
® Municipality ofAnchorageAVltf�vpDe artment of Health and Human Services
825 "L" Street
Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
http://www.ci.anchorage.ak.us
June 26, 1998
Robert2C. Cowan, P.E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 5 Block 1 Birch Tree Estates
Waiver Request #WR990027, FID 4017-141-46, HA980157, SW980164
Dear Mr. Cowan:
Your request for a waiver of the required 10 foot separation
between an on-site wastewater disposal system and a lot line has
been approved. The waived distance is 3 feet from the leachfield
to the west property line.
This approval applies to the existing on-site wastewater disposal
system lot line separation only. Any future upgrade to the on-site
wastewater disposal system will require all separations be met or
another approval from this department.
If there any further questions or concerns regarding this waiver,
please call our office at 343-4744.
Sincerely,
/5��/ a
Daniel J. Roth
Civil Engineer
On-site Services
ljw #7
MUNICIPALITY OF ANCHORAGE'
Department of Health and Human :Services
Onwsi.te Services Section
waiver Review Worksheet
WRJ PI -D# 017-141-46 HA# HA9-80157 Permit # SW980164
Date Received: June 23, 1998
Legal Description_: Lot 5 Block 1 Birch Tree Estates"Subdivision
Engineer: Robert C. Cowan, P.E., B & S- Engineering
17034 Eagle River_Loop Road, Suite 204,
Eagle River, Alaska 99577
Applicant: Lawrence & Pamela=Cartmiil
Waiver Request ed:< Trench to the vest lot line of
3 €eet.
Criteria: 1. Geology:
Points:
A. Water Table
B. Soil -Sorption
C. Permeability
D. Water Table Gradient
E. -`Horizontal Separation`
TOTAL:
2 Special Conditions.
3. Other:
Waiver is Granted: Waiver is
NOT Granted:
List`Conditions or Reasons fox above:
Date: By:
Name
of Reviewer
Rec > #: #03920/2129` Amount; $ 115.00
Date Paid: mune 23. 1998
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services an
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # ©17— 1+1--46 —000
1. GENERAL INFORMATION
HAA # 'r--Vaa+.i®Qa-1a
Complete legal description L07— -t5 i2t-4 —
�S-�S
Location (site address or directions) 52-0C' r I vf=—
A,.,,3,- o, , ,4�_-_,
Property owner L y,�N 2.0 z Day phone 345-
Mailing address - AS AGCvE-
Lending agency Day phone
rJ !,4
Mailing address
Agent /pya y- 1 1 f—t 2 TSA -C._ Day phone ?-44-44-72-
Address
-44~44-72-
Address Q (A -
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well _X_
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site X
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
5. STATEMENT OF INSPECTION BY ENGINEER.
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I furtherverify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of thinspection.
Alaska Water R
Wastewater Services
Name of Firm Phone's
Address / / i
7/amuEngineer's signature i Date /(
-= OF
A4
M'
ey`A. Gayness J/
♦ CE -7953
•..•.•
6. DHHS SIGNATURE (� dtj,F�pROFESV3N��4�+
Approved forl bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-M (Rev. 1/91) Baca MOA #21
D. L PF.STATION
Date installed
Manhole/Access (YN)'
High water
tested
E. SEPARATION DISTANCES
Size in
,:.level at*
*Datum
"Pump off' level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
r
Septic/holding tank on lot It) 1 41 ; On adjacent lots ",- t oo
Absorption field on lot 104 +- ; On adjacent lots '::- I 0 O r
Public sewer main 1�1 I Public sewer manhole/cleanout N �4
Sewer /septic service line ► Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 131 + Property line 60 1 + Absorption field 5 '4-
Water
a -
Water main/service line '0- (0 Surface water/drainage 100 Wells on adjacent lots �" I �®
SEPARATION DISTANCFzFROM ABSORPTION FIELD ON LOT TO:
or / /
Building foundation 35 '" Water main/service line a 10
Surface water 0100 Driveway, parking/vehicle storage area 3
NONE t / �� A4 -9 -Lc—
__ drain �ownl Wells on adjacent lots 1OO Property line w0 ! sVt-, J"
F. ENGINEER'S CERTIFICATION
1 certify that 1 ha eter ed thr e d ins ections and review o
f
in conforman with M A'9e Ines itAeffect on this date.
Signature
Engineer's NameOCJJA-
JF �e
Date - '7 �3 0 9 AW
E-7953 •�.�� j
`1;•pROFESSO ;Q'
HAA Fee $ 66-ig dD
Date of Payment
Receipt Number
Rev. 8/95 OSS: haa.wk.doc
Waiver Fee $
Date of Payment
Receipt Number
are
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date _ 1 L
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
5-7-6''0 ?/t/i.7P7_--A/ *ti
(b) Applicant Name R4 c-- -Icd ✓term ; a *,Telephone: Home Business G' / z4s
Applicant Address
(c) Applicant is (check'orie):'Lending 'Institution 1� ; Owner/builder; Buyer 11; Other ❑ (explain);
(d) Lending Institution j° e_ Telephone _
Address _
(e) Real Estate Company and Agent
Address
Telephone _
(f) Mail the HAA to the following address:
2.
TYPE OF RESIDENCE
Single -Family Multi -Family ❑
Number of Bedrooms
Other
3. WATER SUPPLY
Individual Weliv Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
5.. ENGINEERING FIRM PROVIDINu INSPECTIONS, TESTS, FILE SEARCH, DAYA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm Telephone
Address %yoy a 33- /�� iu�/e`� S
Date ���,.&1?6 ✓?2'
4�4®qV1 4
s e��•® 'A`� �®
*Gye490•�./�
•�eeeeee e e
•• %���se•eee
LEROY C REID, JR.E inli�r's Seal
:e C 2251 0904F o
Air
6. DHEP APPROVAL f
Approved for �'�� 3) bedrooms byDate
Approved _ Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHC?jtA0F
DEPT.- OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MO.+) ENVIRONMENTAL ,PROTECTION
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST FEBRUARY 1984 "�j
264-4720
Legal Description: Ld
A. WELL DATA
Well Classification '��� � If A, B, C, D.E.C. Approved (Y/N) 1,4
Well Log Present(9 Date Completed ��" �� 72TYield
Total Depth /S3 Cased to �S3 Depth of Grouting
Static Water Level /0/,7 Pump Set At
i
Casing Height Above Ground `� Sanitary Seal on Casing(9q)
Electrical Wiring in Conduit©N) Depression Around Wellhead (yo
Separation Distances from Well:
To Septic/Holding Tank on Lot ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot On Adjoining lots
To Nearest Public Sewer Line
A To Nearest Public Sewer
Cleanout/Manhole To Nearest Sewer Service Line on Lot 75',,
Water Sample Collected by lWeS A G✓10 Date 60-��
Water Sample Test Results SVEWT-OR/
Comments / W*Z.(- rzo+J ,TLz3TG /� 8l'0
B. SEPTIC/HOLDING TANK DATA
1
Date Installed 7-4-77- Size Zpfy E7� No of Compartments
StandpipeseN) Air -tight Caps l) Foundation Cleanout (Yal
Depression over Tank (Yo Date Last Pumped !e -/7_8L
Pumping/Maintenance Contract on File (Y/N) 14 ; for 4
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Well LPs To Building Foundation
To Property Line �� �' To Disposal Field - Z
i
To Water, MaiNSer■pice Line /0 t To Stream, Pond, Lake, or Major Drainage
Course
Comments
-,Page 1 of 2
72-026(11/84)
4_!5" 151 61ZJ91rea3r e57 -
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata S© �Type of System Design , 44;'AIJs0tb
X14i��
Date Installed U06&&O 8-z7--r/io-m-zs Length of Field 417
Width of Field 5, Depth of Field X S
i
Gravel Bed Thickness �•S
Square Feet of Absorption Area Standpipes Present (1' N)
Depression over Field (Y N Date of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well /O� To Property Line /%
To Building Foundation
O
Lot
_56 1
i
To Water Main/Service Line /0
To Stream/Pond/Lake/or Major Drainage Course
To Existing or Abandoned System on
r
On Adjoining Lots
To Cutbank (if present)
/170,fi
To Driveway, Parking Area, or Vehicle Storage Area n1 ,r / — 16 AT >FUAIT of 7rval*1 A&r,#eTJ u1V Vx�';44r
Comments Gear Ayftw La -m e "jnwv /.0,+
D. LIFT STATION
Date Installe Dimensions
Size in Gallons Manhole/Access (Y/N)
"Pump On" Level at "Pump Off' Level at
High Water Alarm Level at Vent (Y/N)
Tested for �ings during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
1 certify that I ha he ed, vrified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed �� Date
G -i9--
CompanyCf MOA No. �S"o ♦��o����
•' OF A4
Receipt No.ba. 4 - S �
Date of Payment — r �:• TH ;�*e`
o
Amount: $ _ +
f • .*fee . .. ...
A4VI- 'If
z t�,f�efz ,%�46r, ,�esa�TS ��+ %.� • 2251 ••' /
Page 2 of 23 _ sr��••....••'A
• pwon �
1*a MAR S--17--P/ilk%.i; ..••
72-026 X11/84)
ALASKA �► tOIROWnTAL COnTROL %)JIRS, InC.
6ngineerinq & Enuironmental Studies
.JUNE 19 1986
CAULDWELL BANKER SELLER—LOIS HODGES CAULDWELL BANKER
4105 TUDOR CENTER 4105 TUDOR CENTER
ANCHORAGE ALASKA ANCHORAGE ALASKA
99508 99508
60285
LEGAL:BIRCH TREE ESTATES BLOCK 1 LOT 5
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE—,JUNE 17 1986
THE TYPE OF ABSORPTION SYSTEM IS A DRAINFIELD WITH AN AREA OF 582 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS.
ED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 EDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 25IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON .JUNE 17 1986 .
THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
FLOW TEST ON WELL
WELL FLOW DATE—JUNE 17 1986
A FLOW TEST WAS PERFORMED ON THE WELL. 682 GALLONS OF WATER WAS
PUMPED AT A RATE OF 4.5 GPM OVER A DURATION OF 2.5 HOURS.
THE DRAWDOWN WAS 34.9 ' WITH A RECOVERY TIME OF 100 MINUTES
AND THE STATIC WATER LEVEL WAS 101.7 FEET.
THE WELL IS ADEQUATE FOR THIS(3) BEDROOM HOME.
r
r
33rd Auenue, Suite B • Anchorage, Alaska 99503 9 (907) 561-5040
ALASKA ENVIRONMENTAL JOB Lp7"S B�ocX / $�QG�/T,er e3T
CONTROL SERVIC 7, INC. SHEET NO. OF
1200 West 33rd Avenuc, Suite B
ANCHORAGE, ALASKA 99503 CALCULATED BY • DATE _
(907) 561.5040
CHECKED BY DATE
SCALE-
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 5 Block 1 Birch Tree Estates
Location (address or directions)
5200 Riverton Avenue
(b) Applicants Name Larry Clark Telephone - Home Business
Applicants Address 3201 C Street
(c) Applicant is (check one) Lending Institution Owner/builder ;
Buyer E::l ; Other RX7X (explain); Realty
(d) Lending Institution Telephone
Address
(e) Real Estate Co. & Agent Larry Clark % Jack White Company
Address 3201 C Street, Anchorage, Alaska 99503
Telephone 563-5500
(f) Mail the HAA to the following address:
2. Type of Residence
Single -Family' "
Number of Bedrooms
3. Water Supply
Multi -Family
three (3)
Other (describe)
Individual Well al Community M Public M
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite FK1 Public =1 Community F-1 Holding Tank =
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of Structure Ind3C atm betAft- I iutthor veri iy tliat,
based on the information obtained from the Municipality of anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm
Address
Date
(ENGINEER SEAL)
6. DHEP Approval
Approved for three bedrooms
Approved xx Disapproved
Terms of Conditional Approval
Telephone
This Department has received
the original and it is on file
with Department from the engineer
This property has been reviewed
and approved by this Department.
By A`�c. Date Sept 6, 1984
CAUTION
Conditional
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7-19-84
11
MUNICIPALITY OF ANCHORAGE (MOA)-
HEALTH AUTHORITY APPROVAL (HAA) ML'NICiPa.rrn of ANCH DEPT. OF HEALTH &�
CHECKLIST FEBRUARY 1984 ENVIRONMENTALPROTEMON
Jic17hee B APR 2 ,5 iuHu
A. WELL DATA
Well Classification
If A B c D.E.C.R 3VE.D
Well Log Present N) Date Completed !! /� Yield*! • ,t!Y: rl
Total Depth _ f Caked to Depth of Grouting A) �A-
Static Water Level 76 Pump Set At
Casing Height Above Ground . $�� _ Sanitary Seal on Casing ON)
Electrical Wiring 'in Conduit i%) Depression Around Wellhead {Y
Separation Distances from Well:
To Septic/Holding Tank on Lot 107 �' ; On Adjoining Lots /00
To Nearest Edge of Absorption Field on Lot /%6i! On Adjoining Lots LOQ.,
To Nearest Public Sewer; mine "tel A, To Nearest Public Sewer
Cleanout/Manhole .----�=-4 To Nearest Sewer Service Line on Lot ---'=f----p
Water Sample Collected By Date�j
Water Sample Test Results
Camiants ICG�I -
B. sEprlC/Hor.DING TANK DATA
Date Installed 1,2 lq' Size l bZ� No. of Compartments
pip
- Standpipes Y�N) Air-tight Caps isto Foundation Cleanout (Y (T
Depression over Tank (YI0 Date Last Pumpedpkv .
s
Pumping/Maintenance Contract on File (Y ) ; for °
Holding Tank High-Water Alarm (Y/N) (SIA_ Temporary Holding Tank Permit (Y/N) A_
Separation Distances frcm Septic/Holding Tank:
To Water-Supply Wb-11 0 - rt To Building' Foundation�E-
To Property Line -�- f (� 'To Disposal Field
To Water Main/Service Line To Streamo, Pond., Lake, cr MaJor Drainage
Course
Ccmnents
__4v Lvw_ r
k&1 04�n.Cl l vr. Gi t.�oL1C✓�r+e;— w CGxP�-e�li GvoC
[Page 1 of 2 ]n (��u ,�-.�
��d`�'l''bt' 2-15-54
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata /,5Z tW Type of System Design .(r
Date Installed ,�pC Length of Field 5-71
■Ir�4
Width of Field Depth of Field 57
Gravel Bed Thickness, _3,S/
Square Feet of Absorption Area Standpipes Present tsvd)
Depression over Field (Y/N)& Date of Last Adequacy 'lest
Results of Last Adequacy Zest
Separation Distance from Absorption Feld:
To Water -Supply Well �1 D � � To Property Line /o' �, oro 6cai �7" J
To Building Foundation ��; ' To Existing or Abandoned System on
Lot On Adjoining Lots
To Water Main/Service Line ),q To Cutbank(if present) T
To Stream/Pond/Lake/or Major Drainage Course N IA -
To Driveway, Parking Area, or Vehicle Storage Area
Comments -
R9
D.0'LIFT STATION ', PDklr15-
Date Installed
Size in Gallons
Dimensions
Manhole/Access (YM)
"Pump On" Level at "Pump Off" Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Zest. Meets MOA
Electrical Codes(Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect
on the date of this inspection.
Signed DateD
Company C MOA No. ' �-D22V
RB1 /d5/s -
[Page 2 of 21
P
2-15-84
`- E a) �=1� ��r�.�s���� (fin
I
5. LEGAL DESCRIPTION
,I
DATE RECEIVED
INSPECTION APPOINTMENTS
STREET LOCATION
Tii/iE
TIME
TIME
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
❑ One ❑ Four ❑ Other
--)
DATE
DATE
DATE
7. WAT€R SUPPLY
XX INDIVIDUAL* *ATTACH
WELL LOG. A well log is required for all wells drilled
7.t
INSPECTOR
INSPECTOR
INSPECTOR
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
YEAR ON-SITE SYSTEM WAS INSTALLED.
)J
LJ—)
MUNICIPALITY OF ANCHORAGE
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
V-
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DI RECTI ONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER
PHONE
r
MAILING ADDRESSAot
PROPERTY R SIDENT (If-differerit from above)
PHONE
2. BUYER
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTOR/AGENT
�--
PHONE
�
�� OL ,hdi
�� ���
MAILING ADDRESS /�
4 %'�R
Fav[ t��I tl q���
5. LEGAL DESCRIPTION
,I
L 5 / I, -c h Jk_:,�_e.
STREET LOCATION
s!_ (� ALe -
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
❑ One ❑ Four ❑ Other
SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
J�C Three ❑ Six
7. WAT€R SUPPLY
XX INDIVIDUAL* *ATTACH
WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE d\THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
C21' INDIVIDUAL
❑ COMMUNITY
El PUBLIC UTILITY��
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
7 y
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
E91NDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
C
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: / ,Z- S 0 If Tank is homemade
give dimensions:
SOILS RATING
Isle,
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
L(% 12
❑ APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY
72-010 (Rev. 6/79)
ALASKA HU1RMRAL COnTROL SCRUIRS, InC.
engineerinq & enuironmental Studies
September 6, 1984
T0: DHEP
SUBJECT: Lot 5 Block 1 Birchtree Estates
ATTENTION: Susan Oswald
This letter is in response to the conditional for the Health
Authority Approval on subject lot.
(1) Ten feet of trench removed and relocated as to
not encroach on neighbors well.
(2) The 2X4 frame around septic tank clean out has
been capped with a 2X6 lid to protect air tight
cap.
(3) The trench clean out at edge of gravelled area
has been extended and a 6X6 wooden beam has been
installed as a barrier.
If you have any further questions, please feel free to contact
me at: 561-5040.
Sincerely,
John Gates
Engineering Technician
JG/sc
Approved by:
1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 • 907) 276-1361
of
,04, -Elmer -I 4 -4 -
ANG, 110 1 UV i I, At /N,;;I�A 9950,' Pig ,II
(90 6 .)("-1 :1 1 1 1
IW'", kN(,Tvt s
AIA Y( )/;
DEPARTMENT OF HEALTH AND FNVIRONM[N1AL PROTECTION
May 17, 1934
Ms. Gwen Turner
Alaska Environmental Control
Services, Inc.
1200 West 33rd Avenue, Suite B
Anchorage, Alaska 99503
RL,: 13i.r.chtree Estates, Lot 5, Block 1, TIAA
Dear Ms. Turner:
In responses to your letter. dated May 2, 1.984, l -.his Department
will continue to allow the septic tank to remain under the dri-
veway, even though when first- installed this cond.it-ion was not
anticipated. However, the prospective property owner should be
marle aware of the current situation and any potential safety
hazard sIiou1.d the structure fail and cave in. Please address the
presence and condition of the septic tank cleanout.
The tr.-enc li cleanout next to the driveway, as mentioned ill your
letter, must be protected and properly capped off_.
It was also noted from the as -built di -gram attachedto your
letter that a neighboring well is within 96 feet of the end of
the trench dr.ainfield on,.the subject property. This will pre-
sently require a waiver (from the State D.E.C.
Please call. me at 264-4720 if you have any questions.
Sincerely,
Keith E. Bandt
Environmental Engineering
Manager
KB4/ej/D16
ALASKA bUIROWnTAL COnTROL HMUS, InC.
Cngineerinq & enuironmental Studies
Department of Health and
F,nvir.onmental Protection
825 1, Street
Anchorage, Alaska 99501
Attn: Keith Bandt
Legal: Birchtree F,staf:es Lot 5 Block 1
Dear Keith:
May 02, 1984
r31d liT n 0�
DIP RNA
Or' HEAL
ON,
(;,IIA r I I 1TECrI
984
RECEIV h
E
Attached is a diagram of the above property as per your request. As
you can see from the location of the septic tank in front of the
garage, it is impossible to reroute the drive and be able to utilize
the right—hand garage. The garage is a two—door one, and the septic
tank is situated almost in the center of the two doors and 2.0' out
from them.
As noted on the 1978 upgrade inspection Form, the tank is a 1250
gallon tank, composed of steel, with a diameter of 5'8" and is in an
upright position. As measured, the top of the septic rank is located
2.5' belowgrouad. At the time of the inspection the house was
indicated as "proposed" and a trailer was on the lot. There was no
indication of a drive being located over the system.
The trench clean—out located at the beginning of the trench is just 1"
from the edge of the drive proper, it is set in a wooden frame and cut
off at ground level. It could easily be protected by a barrier that
would not impinge upon the driveway or garage access and yet would
protect the cleanout.
At the time of this HAA, snow cover prevented the location of the end
standpipe to the trench. Since then the pipe has been located. It is
6" aboveground and capped. Please note this for your files.
In a previous HAA, the inspector apparently had no difficulty with the
present location of the septic tank and a HAA was granted in 12/82.
In light of this, we would like to request_ that t:he system be approved
as it is.
If you have any further questions, please contact me.
Sincerely,
wen Turner
avironmental Scientist
1200 West 33rd Auenue, Suite B • Anchorage. Alaska 99W3@(907) 561-5040
ALASKA ENVIRONM...4TAL JOB L
CONTROL SERVICES, INC. SHEET NO. OF
1200 West 33rd Avenue Suite B
ANCHORAGE, ALASKA 99503 CALCULATED BY DATE
Phone 2761361 CHECKED BY DATE_
SCALE
ALASKA 6101ROWNAL CONROL SCrOUS, InC.
6ngineerinq & 6nuironmental Studies
July 2, 1984
Larry Clark
Jack White Realty
3201 C Street
Anchorage, AK 99503
RE: Lot 5 Block 1 Birchtree Estates
Dear Mr. Clark:
As a result of the denial of our Request for Waiver of the
well to septic system distance, part of the trench on this lot
will have to be re -located. At your request, I am also
detailing the other corrections needed to obtain a Health
Authority Authorization from the Dept. of Health and
Environmental Protection (DHEP).
For the trench relocation:
(1) Take this letter to the DHEP and obtain a permit for the
septic system relocation.
(2) Measure 100' from the wells on lots 5,4, and 13 (see
diagram) to the location on lot 5 and flag the distances.
(3) Dig up and remove the pipe and gravel of any part of the
trench that lies within the 100' radius of any of the wells.
Depending on how, the trench curves, this can be anywhere from
10-20 feet. It might be best to give yourself an extra few
feet leeway.
(4) Tee off the trench at a point beyond the 100' radius, dig
a new trench off the old one, heading east or west. The new
trench will be as long as the length that was dug up. This
would provide an excellent opportunity to add on an extra 5-10
feet as a buffer against future failure.
(5) An engineer/inspector will have to confirm the
abandonment of the trench within the 100' radius, plus provide
two inspections for the new trench.
Trench cleanout at edge of gravelled area:
The pipe has to be extended to at least 1' aboveground and a
barrier of some sort placed between the cleanout and any
chance of being driven over. The barrier should be at least
1200 fest 33rd Auenue. Juile B 9 Anchorage. Alaska 99503 • (907) 561-5040
5' from the cleanout. A log, 6x6, or some other solid
structure can be used for the barrier.
Septic tank standpipe:
The frame surrounding the septic tank standpipe must have a
lid put on it to protect the air -tight cap. The lid should be
at least 3/4" thick to provide support from vehicles being
driven over it.
The new owners should be informed of the location of the
septic tank and warned that there is a chance of collapse if
heavy vehicles overuse the area. It is considered safe for
driving over to reach the garage, but care should be taken to
avoid consistantly parking over the tank.
If you need any further information please feel free to call
our office.
Sincerely,
_—
G
Gwen Turner
Environmental Scientist
Approved:
cc: DHEP
ALASKA ENVIRONMENTAL JOB__
CONTROL SERVICES, INC. SHEET NO.._._--- --__._ _ OF -
1200 West 33rd Avenue Suite B r.�a- //
ANCHORAGE, ALASKA 99503 CALCULATED BY �""1 ___.__ DATE__..__J¢��,//
Phone 276-1361
CHECKED DATE ---
3v_'
SCALE- --------- _"_
BILL SHEFFIELD, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVA'T'ION Telephone: 1907)
SOUTHCENTRAL REGIO14AL OFFICE Address:
437 "E" STREET, SUITE 200
ANCHORAGE, ALASKA 99501 274-2533
June 12, 1984
Ms. Gwen Turner
_ Alaska Environmental Control
Services, Inc.
1200 W. 33rd Avenue, Suite B
Anchorage, Alaska 99503
Dear Ms. Turner:
Subject: Lot 5, Block 1, Birchtree Estates
�hl)w1C`IP;`,= iTY' <"ii" F�NC.t#C)Ir1^f.
Your letter of June 1, 1984, provided soil information from well logs
of wells adjacent to the well in question on Lot 13.
In order for us to consider the waiver request we need to have a state-
ment from the engineer to the effect that it is their judgement that the
lesser separation distance (90 feet from disposal field on Lot 5 to the
well on Lot 13) will not pose an undue risk to the health of the well
water consumers, due to soil conditions and any other factors providing
protection of the Lot 13 well.
It would be helpful if information could be obtained regarding casement
of the well on Lot 13 and the depth of encasement.
Sincer ly,
Richard M. Farnell
Environmental Engineer
RNF/msm
cc: Robbie Robinson (PIOA)
ALASKA RUIROWnTAL COnTROL SHUNS, InC.
Engineerinq & enuironmental Studies
APRIL 23 1984
LARRY CLARK
3201 C STREET
ANCHORAGE AK 99503
SELLER — JACK WHITE REALTY BUYER —
SUBDIVISION — BIRCHTREE ESTATES BLOCK — 1 LOT — 5
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 527 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON APRIL 20 1984 .
FLOW TEST ON WELL
THE WELL FLOW RATE WAS 2.1 GPM FOR 5 HOURS.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) 276-1361
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5. LEGAL DESCRIPTION
DATE MECEIVED
INSPECTION APPOINTMENTS
TIME'
TIME
TIME
6. TYPE OF RESIDENCE
n
DATE
DATE
DATE
❑ Two ❑ Five
❑ MULTIPLE FAMILY
— _-2 "
INSPECTOR
INSPECTOR
INSPECTOR
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT
ECTI 1PNVI RONMENTAL P!' OTECTION
825 L Street - Anchorage, Alaska 99501
•
IN! 2 t1 1981
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720
V E D
� �A�kl
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE]TIES
DI RECTI DNS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. OPERTY OWNER
I PHONE
(LING ADDRESS
ox -
PR PERTY RESIDENT (If different from above)
I
PHONE
2. BUYER
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
1701 (f -S77-, ffit/C�drr'A� 9 �' i�3
f
5. LEGAL DESCRIPTION
STREET LOCATION
f/G �
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
0— Three ❑ Six
7. WATER SUPPLY
0 INDIVIDUAL*
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)p
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79) '
Qt�lltf
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE
❑ TWO
❑ THREE ❑ FIVE ❑ OTHER
❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑ INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
(�
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size:Q-30 If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL _
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
lt, APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
2--- L/ )
BY
72-010 (Rev. 6/79)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
Environmental Sanitation Division
825 L Street - Anchorage, Alaska 99504 Telephone 264-4720
CERTIFICATE OF INSPECTION
SEWER AND WATER FACILITIES
1. PROPERTY OWNER
DONALD E. CARROLL
MAILING ADDRESS
SRA BOX 324 C ANCHORAGE AKK 99507
2. LEGAL DESCRIPTION
Lot 5 Block 1 Birch Tree Estate
3. TYPE DWELLING '
C3A SINGLE FAMILY RESIDENCE 0 OTHER (Describe)
0 MULTIPLE FAMILY RESIDENCE
4. WATER SUPPLY
11 INDIVIDUAL
0 COMMUNITY/PUBLIC
5. SEWAGE DISPOSAL
M INDIVIDUAL/ON-SITE
0 PUB LIC UTILITY
0 HOLDING TANK (Maintenance Required)
X] APPROVED FOR THREE BEDROOMS
ED CONDITIONAL APPROVAL (See Attached) SE. AL"'
0 DISAPPROVED
DATE
BY (TITLE)
12-4_81
Robert C. Prat R.S. Associate Specialist
72-014 (3/78)
5. LEGAL DESCRIPTION
DATE RECEIVED
INSPECTION APPOINTMENTS
M
00
TIME
TIME
TIME
:An
pal
DATE
DATE
DATE
❑ Two ❑ Five
❑ MULTIPLE FAMILY
iZ Three ❑ Six
7. WATER SUPPLY
INSPECTOR
INSPECTOR
INSPECTOR
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
ICI?"LITY OF XNCHORAUL
MUNICIPALITY OF ANCHORAGE
001. OF' &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOKNVIkONty1�'N1"',L i ,. fILCTION
825 L Street - Anchorage, Alaska 99501
IlCr YEAR ON-SITE SYSTEM WAS INSTALLED.
0*
MAR 17 980
ENVIRONMENTAL SANITATION DIVISION
Telephone 264.4720
RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITI-a
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. P ERTY OWNER ©�
_PHONE � f�s�
< O
MAII G ADDR S
,XA'3 3, Y- If
PROPERTY RESIDENT (If different from above)
PHONE
2. BUYER
P O
MAILING ADDRESS
3. LENDING INSTI UTION
PHONE
MAIL NG ADDRESS
zao
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
a%-
t' sz
STREET LOCATION
✓v O`
Oflieo
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
iZ Three ❑ Six
7. WATER SUPPLY
0" INDIVIDUAL*
*ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
F INDIVIDUAL/ON-SITE**
IlCr YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
--
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: 1 � V If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY
72-010 (Rev. 6/79)
MUNICIPALITY OF ANCHORAGE
Department of Health and Environmental P'"".t,
825 L Street, Anchorage, Alaska 901541
279-2511, eXt. 224, 225
quest for Approval of Individual Sewer
!Property :Owner :
I
and Water nl_i t, 11 e`s
CIA
11, I ik - k-�s 2
'Mailing Address: (C)Q ( I
Phone:
f
'Name of Buyer: C)„"()
�Mailing Address:
Lending Institution:
a CA
Phone:
!Mailing Address: I -)r),
+0 G4 Phone:
�1!4. �Realtor/Agent:
Mailing Address: Phone:
5. 'Legal Description:
�Street Location:
16.
7.
I �
!!Single Family Residence*
II
(V Number of Bedrooms:
Multiple Family Residence:
'Water Supply: *Individual. Well
!'If Individual Well, well depth
Number of Bedrooms:
(V Public/Community System ( )
If Community System, name of system
8. 'Sewage Disposal. System: On-site System
If On-site System, date of installation:
0 Public System ( )
A well log is required on ALL wells drilled since 6/75.